Organization Active NPI

Chestnut Ridge Cypress LLC

Doing business as Chestnut Ridge Nursing and Rehabilitation Center

  • Skilled Nursing Facility
  • Cumming, GA
National Provider Identifier
1982025920
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CHESTNUT RIDGE CYPRESS LLC
Doing business as
Chestnut Ridge Nursing and Rehabilitation Center
Practice address
125 Samaritan Dr
Cumming, GA 30040-2354
Phone
(770) 889-0120
NPI assigned
Dec 18, 2013
Last updated
Jan 19, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
CYPRESS SKILLED NURSING LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Isaac Y Ovits
Title
Cfo
Phone
(845) 694-6055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

125 Samaritan Dr
Cumming, GA 30040-2354

Mailing address

125 Samaritan Dr
Cumming, GA 30040-2354
Phone (770) 889-0120

Other names 1

  • Chestnut Ridge Nursing and Rehabilitation Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140317000319 GA Part A Provider - Skilled Nursing Facility 9638300684 Practice locations: Cumming, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982025920. Details of each certification follow.

Skilled nursing facility certification: CCN 115423

Legal name
CHESTNUT RIDGE CYPRESS LLC
Doing business as
CHESTNUT RIDGE NURSING AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 1989
Last certification
Feb 2, 2025
Beds
150
Ownership / control type
Limited Liability Corporation
Multi-facility organization
CYPRESS SKILLED NURSING
Organization structure
LLCProprietary
Enrollment address
125 Samaritan Dr
Cumming, GA 30040-2354
Nursing home name
CHESTNUT RIDGE NSG & REHAB CTR
Affiliated entity
CYPRESS SKILLED NURSING

Care Compare: Nursing home

Medicare Care Compare
Listed as
Chestnut Ridge NSG & Rehab CtrCCN 115423 · All quality measures
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jul 1, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
150130.0 residents per day on average
Chain
Cypress Skilled Nursing5 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
CHC - Chestnut Ridge Nursing Rehab Ctr LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 20

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Cypress Skilled Nursing LLC Organization, Pomona, NY LLC, Management services company, For-profit, Chain home office, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Nov 12, 2013 100%
Operational/Managerial Control Jan 1, 2014
Adp of the SNF Nov 18, 2025
Sara Bender Individual Operational/Managerial Control Jul 2, 2025
Adp of the SNF Jul 2, 2025
Cypress Operating LLC Organization, Pomona, NY LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Nov 12, 2013 100%
Individual Adp of the SNF Apr 1, 2024
SNF TR Organization, Savannah, GA For-profit Indirect Ownership Interest Nov 12, 2013 50%
Timothy Patterson Individual Operational/Managerial Control Sep 6, 2022
Adp of the SNF Sep 6, 2022
Brent Moss Individual Operational/Managerial Control Mar 5, 2025
Adp of the SNF Mar 5, 2025
Elizabeth Nardiello Individual Operational/Managerial Control Mar 11, 2018
Adp of the SNF Mar 11, 2018
Isaac Y Ovits Individual Operational/Managerial ControlCfo Jan 1, 2014
Managing Control - Governing BodyCfo Jan 1, 2014
Adp of the SNF Jan 1, 2014
Maria Macatula Individual Operational/Managerial Control Jul 31, 2017
Adp of the SNF Jul 31, 2017
Michael Whipple Individual Operational/Managerial Control Jan 8, 2001
Adp of the SNF Jan 8, 2001
Karen Phillip Individual Operational/Managerial Control Jul 21, 2024
Adp of the SNF Jul 21, 2024
Dianne W Patterson Individual Operational/Managerial Control May 7, 2018
Managing Control - Governing BodyCorporate Manager May 7, 2018
Adp of the SNF May 7, 2018
Faizan Shaikh Individual Operational/Managerial Control Jun 6, 2025
Adp of the SNF Jun 6, 2025
Individual Adp of the SNF Aug 7, 2017
Organization, Far Rockaway, NY LLC, For-profit Adp of the SNF Dec 22, 2014
Enin TR Organization, Savannah, GA For-profit Indirect Ownership Interest Nov 12, 2013 50%
Organization, Plano, TX LLC, Medical provider/supplier, For-profit Adp of the SNF Nov 18, 2025
Organization, Portland, OR LLC, Consulting firm, For-profit Adp of the SNF Jun 17, 2025
Katherine L Nordholm Individual Operational/Managerial Control Jan 1, 2014
Adp of the SNF Jan 1, 2014

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 6

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1982025920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 SAMARITAN DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402354",
            "telephone_number": "770-889-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SAMARITAN DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402354",
            "telephone_number": "770-889-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTNUT RIDGE CYPRESS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CYPRESS SKILLED NURSING LLC",
        "enumeration_date": "2013-12-18",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "OVITS",
        "authorized_official_first_name": "ISAAC",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "845-694-6055"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chestnut Ridge Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Chestnut Ridge Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.