NPIMap

Organization Active NPI

Vinson Hall, LLC

  • Nursing Facility/Intermediate Care Facility
  • MC Lean, VA
National Provider Identifier
1992093553
Registry record updated Jul 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
NH2480 Issued in VA
Legal business name
VINSON HALL, LLC
Practice address
1739 Kirby Rd
MC Lean, VA 22101-4817
Phone
(703) 506-6900
NPI assigned
Jul 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2011

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

Authorized official

Name
Mr. Robert Clements
Title
Cfo
Phone
(703) 538-2971

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X FLO676570L154 VA
Nursing Facility/Intermediate Care Facility 313M00000X NH2480 VA Primary

Addresses

Primary practice location

1739 Kirby Rd
MC Lean, VA 22101-4817

Mailing address

6251 Old Dominion Dr
MC Lean, VA 22101-4827

Other names 1

  • Arleigh Burke Pavilion Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111201000292 VA Part A Provider - Skilled Nursing Facility 4981878949 Practice locations: McLean, VA

Skilled nursing facility certification: CCN 495410

Legal name
VINSON HALL LLC
Doing business as
ARLEIGH BURKE PAVILION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 17, 2012
Last certification
Jan 15, 2025
Beds
49
Ownership / control type
Nonprofit Corporation
Organization structure
LLCProprietary
Incorporated
Jun 17, 2011 in VA
Enrollment address
1739 Kirby Road
McLean, VA 22101-4817
Nursing home name
ARLEIGH BURKE PAVILION

Care Compare: Nursing home

Medicare Care Compare
Listed as
Arleigh Burke PavilionCCN 495410
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Dec 17, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4944.0 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Vinson Hall LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Individual Adp of the SNF Feb 1, 2024
Richard Mazza Individual Corporate OfficerCfo Apr 7, 2024
Operational/Managerial Control Apr 7, 2024
Nmcgr Organization, McLean, VA Non-profit 5% Or Greater Direct Ownership Interest Jun 17, 2011 100%
Organization, Madison, WI Consulting firm, For-profit Adp of the SNF Jun 25, 2025
Robert Roe Individual Corporate OfficerChief Executive Officer Jul 19, 2022
Operational/Managerial Control Jul 19, 2022
Organization, Springfield, MO Adp of the SNF Jun 25, 2025
Vinson Hall LLC Organization, MC Lean, VA LLC, Non-profit Operational/Managerial Control Jun 30, 2011
Analisse Vasquez Soto Individual Operational/Managerial Control Aug 29, 2022
Adp of the SNF Sep 30, 2025
Organization, Roanoke, VA Consulting firm Adp of the SNF Jun 25, 2025
Cissy Paul Pottanat Individual Operational/Managerial Control Sep 1, 2022

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 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310947200000",
    "number": "1992093553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6251 OLD DOMINION DR",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221014827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1739 KIRBY RD",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221014817",
            "telephone_number": "703-506-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINSON HALL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-18",
        "last_updated": "2011-07-18",
        "status": "A",
        "authorized_official_last_name": "CLEMENTS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "703-538-2971",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "VA",
            "license": "FLO676570L154",
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "VA",
            "license": "NH2480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arleigh Burke Pavilion",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in MC Lean, VA

Sources for this page

Verify at the official NPI Registry.