SHIPPENVILLE PA OPCO LLC
NPI 1083467294
Skilled Nursing Facility in Shippenville, PA

Active since April 08, 2024CLIA 39D0183336 · Waiver
21158 PAINT BLVD, SHIPPENVILLE, PA 16254(814) 226-5660 Get Directions Write a Review

NPPES record last updated: April 8, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shippenville Pa Opco Llc NPPES

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

SHIPPENVILLE PA OPCO LLC (NPI 1083467294), doing business as Shippenville Nursing And Rehab, is a healthcare organization registered as a skilled nursing facility in Shippenville, Pennsylvania and active in the NPI registry since April 2024. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Aharon Franco, Authorized Representative, as its authorized official.

NPPES Registry Identity

NPI1083467294
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameSHIPPENVILLE PA OPCO LLC
Location Address21158 PAINT BLVDShippenville, PA 16254-4024
Mailing Address1815 Lakewood Road, Suite 255Toms River, NJ 08755
Organization SubpartNo
Authorized OfficialAharon FrancoAuthorized Representative · (646) 823-6464
Enumeration DateApril 8, 2024
NPPES CertifiedApril 4, 2024
NPI 1083467294 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.
21158 PAINT BLVD, Shippenville, PA 16254

Other Names 1

Doing Business AsShippenville Nursing And Rehab

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 39D0183336

Shippenville Nursing & Rehab · Shippenville, PA
Active · expires Aug 31, 2026
CLIA Number39D0183336
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorDr. Howard Fugate III
Laboratory Phone(814) 265-1164
Laboratory LocationShippenville Nursing & Rehab21158 Paint Boulevard, Shippenville, PA 16254
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

Skilled Nursing Facility
21158 PAINT BLVD
SHIPPENVILLE, PA 16254
Physical Therapist
21158 PAINT BLVD
SHIPPENVILLE, PA 16254
Skilled Nursing Facility
21158 PAINT BLVD
SHIPPENVILLE, PA 16254
Speech-Language Pathologist
21158 PAINT BLVD
SHIPPENVILLE, PA 16254

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 Shippenville PA Opco LLC's NPI number?

The NPI number for Shippenville PA Opco LLC is 1083467294. It was assigned to this organization in the NPPES registry on April 8, 2024. The provider is doing business as Shippenville Nursing and Rehab.

Where is Shippenville PA Opco LLC located?

Shippenville PA Opco LLC is located at 21158 Paint Blvd, Shippenville, PA 16254. The listed phone number is (814) 226-5660.

What is Shippenville PA Opco LLC's specialty?

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

Does Shippenville PA Opco LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D0183336) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Shippenville PA Opco LLC was last updated on April 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.