FOREST AVENUE OPCO, LLC
NPI 1396213492
Skilled Nursing Facility in Jackson, MS

Active since November 06, 2018CLIA 25D0697511 · Waiver
1/5
Overall Rating
1116 FOREST AVE, JACKSON, MS 39206(601) 366-6461(601) 362-4041 Get Directions Write a Review

NPPES record last updated: November 6, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Forest Avenue Opco, Llc NPPES

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

FOREST AVENUE OPCO, LLC (NPI 1396213492), doing business as Pine Forest Health And Rehabilitation, is a healthcare organization registered as a skilled nursing facility in Jackson, Mississippi and active in the NPI registry since November 2018. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists John Thomas Fick, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1396213492
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameFOREST AVENUE OPCO, LLC
Location Address1116 FOREST AVEJackson, MS 39206-3216
Mailing Address9020 Overlook Blvd Ste 202Brentwood, TN 37027-2755 · (615) 250-7100 · Fax (615) 250-7101
Fax(601) 362-4041
Organization SubpartNo
Authorized OfficialJohn Thomas FickChief Financial Officer · (615) 250-7100
Enumeration DateNovember 6, 2018
NPI 1396213492 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.
1116 FOREST AVE, Jackson, MS 39206

Other Names 1

Doing Business AsPine Forest Health And Rehabilitation

Accepted Insurance

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 25D0697511

Forest Avenue Opco, LLC Dba Pine Forest Health And Rehabilitation · Jackson, MS
Active · expires Aug 31, 2026
CLIA Number25D0697511
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorMargaret Heggins
Laboratory Phone(601) 366-6461
Laboratory LocationForest Avenue Opco, LLC Dba Pine Forest Health And Rehabilitation1116 Forest Avenue, Jackson, MS 39206
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Pine Forest Health And Rehabilitation (CMS certification number 255326), from CMS Care Compare.

Pine Forest Health And Rehabilitation

Nursing home · Jackson, MS
1/5 CMS Overall Rating
OwnershipFor profit - Limited Liability company
CMS Certification Number255326
Certified Beds120 beds97 residents per day on average
Medicare & Medicaid Participant SinceJune 1, 2008
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
2/5
Long-Stay Quality
Quality of care delivered to long-term residents.
2/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
3/5
Staffing
Based on nursing staff hours relative to resident needs.
2/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
194.67
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 2.31 · LPN 1.07 · RN 0.56
3.94 hrs per resident per day
Weekend Nurse Staffing
3.07 hrs per resident per day
Physical Therapist Staffing
0.05 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
64.8%
Registered Nurse Turnover
70.6%
Administrators Who Have Left
In the past year.
0
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

CMS has flagged this facility with its abuse flag, indicating a citation for abuse or neglect on a recent inspection report.
Facility-Reported Incidents
1
Substantiated Complaints
4
Fines
2 totaling $68,058.25
Medicare Payment Denials
0
Total Penalties
2
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

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.

Internal Medicine
1116 FOREST AVE
JACKSON, MS 39206
Skilled Nursing Facility
1116 FOREST AVE
JACKSON, MS 39206
Internal Medicine
1116 FOREST AVE
JACKSON, MS 39206
Family Medicine
1116 FOREST AVE
JACKSON, MS 39206

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 Forest Avenue Opco, LLC's NPI number?

The NPI number for Forest Avenue Opco, LLC is 1396213492. It was assigned to this organization in the NPPES registry on November 6, 2018. The provider is doing business as Pine Forest Health and Rehabilitation.

Where is Forest Avenue Opco, LLC located?

Forest Avenue Opco, LLC is located at 1116 Forest Ave, Jackson, MS 39206. The listed phone number is (601) 366-6461.

What is Forest Avenue Opco, LLC's specialty?

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

Does Forest Avenue Opco, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D0697511) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Forest Avenue Opco, LLC a Medicare-certified nursing home?

Yes. Pine Forest Health And Rehabilitation is a Medicare-certified nursing home with 120 certified beds.

What quality rating does Forest Avenue Opco, LLC have?

CMS rates Pine Forest Health And Rehabilitation 1 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Forest Avenue Opco, LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee and 1 other insurer list Forest Avenue Opco, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Forest Avenue Opco, LLC was last updated on November 6, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.