400 SOUTH INDEPENDENCE AVENUE OPCO LLC
NPI 1033927074
Skilled Nursing Facility in Independence, VA

Active since December 23, 2024CLIA 49D0947821 · Waiver
400 S INDEPENDENCE AVE, INDEPENDENCE, VA 24348(276) 773-0303(276) 773-0404 Get Directions Write a Review

NPPES record last updated: March 10, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Mar 10, 2025, Feb 28, 2025, Dec 23, 2024 (3 updates tracked since 2024).

About 400 South Independence Avenue Opco Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

400 SOUTH INDEPENDENCE AVENUE OPCO LLC (NPI 1033927074), doing business as Grayson Health And Rehabilitation, is a healthcare organization registered as a skilled nursing facility in Independence, Virginia and active in the NPI registry since December 2024. The organization holds a CLIA Waiver certificate valid through June 23, 2028 and lists Tiffany Hoback, Manager, as its authorized official.

NPPES Registry Identity

NPI1033927074
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business Name400 SOUTH INDEPENDENCE AVENUE OPCO LLC
Location Address400 S INDEPENDENCE AVEIndependence, VA 24348-3972
Mailing Address400 S Independence AveIndependence, VA 24348-3972 · (276) 773-0303 · Fax (276) 773-0404
Fax(276) 773-0404
Organization SubpartNo
Authorized OfficialTiffany HobackManager · (770) 698-9040
Enumeration DateDecember 23, 2024
Last NPPES UpdateMarch 10, 20253 updates tracked since enumeration
NPPES CertifiedMarch 10, 2025
NPI 1033927074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
400 S INDEPENDENCE AVE, Independence, VA 24348

Other Names 1

Doing Business AsGrayson Health And Rehabilitation

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 49D0947821

400 South Independence Avenue Opco LLC · Independence, VA
Active · expires Jun 23, 2028
CLIA Number49D0947821
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateJune 24, 2026
Certificate Expiration DateJune 23, 2028
Laboratory DirectorRobert B. Sword
Laboratory Phone(276) 773-0303
Laboratory Location400 South Independence Avenue Opco LLC400 South Independence Avenue, Independence, VA 24348
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapy Assistant
400 S INDEPENDENCE AVE
INDEPENDENCE, VA 24348
Occupational Therapy Assistant
400 S INDEPENDENCE AVE
INDEPENDENCE, VA 24348
Physical Therapy Assistant
400 S INDEPENDENCE AVE
INDEPENDENCE, VA 24348
Occupational Therapy Assistant
400 S INDEPENDENCE AVE
INDEPENDENCE, VA 24348
Physical Therapy Assistant
400 S INDEPENDENCE AVE
INDEPENDENCE, VA 24348
Speech-Language Pathologist
400 S INDEPENDENCE AVE
INDEPENDENCE, VA 24348
Skilled Nursing Facility
400 S INDEPENDENCE AVE
INDEPENDENCE, VA 24348
Physical Therapy Assistant
400 S INDEPENDENCE AVE
INDEPENDENCE, VA 24348

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is 400 South Independence Avenue Opco LLC's NPI number?

The NPI number for 400 South Independence Avenue Opco LLC is 1033927074. It was assigned to this organization in the NPPES registry on December 23, 2024. The provider is doing business as Grayson Health and Rehabilitation.

Where is 400 South Independence Avenue Opco LLC located?

400 South Independence Avenue Opco LLC is located at 400 S Independence Ave, Independence, VA 24348. The listed phone number is (276) 773-0303.

What is 400 South Independence Avenue Opco LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does 400 South Independence Avenue Opco LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D0947821) is associated with this NPI, valid through June 23, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for 400 South Independence Avenue Opco LLC was last updated on March 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.