HERITAGE HALL - KING GEORGE
NPI 1417449422
Skilled Nursing Facility in King George, VA

Active since June 05, 2018CLIA 49D0679003 · Waiver
10051 FOXES WAY, KING GEORGE, VA 22485(540) 775-4000(540) 775-3637 Get Directions Write a Review

NPPES record last updated: November 25, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Heritage Hall - King George NPPES

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

HERITAGE HALL - KING GEORGE (NPI 1417449422) is a healthcare organization registered as a skilled nursing facility in King George, Virginia and active in the NPI registry since June 2018. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Cassandra Gallant, Compliance & Privacy Officer, as its authorized official.

NPPES Registry Identity

NPI1417449422
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameKING GEORGE LIFE CARE, LLC
Location Address10051 FOXES WAYKing George, VA 22485-3458
Mailing Address10051 Foxes WayKing George, VA 22485-3458 · (540) 775-4000 · Fax (540) 775-3637
Fax(540) 775-3637
Organization SubpartNo
Authorized OfficialCassandra GallantCompliance & Privacy Officer · (540) 774-4263
Enumeration DateJune 5, 2018
Last NPPES UpdateNovember 25, 2024
NPPES CertifiedNovember 25, 2024
NPI 1417449422 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in VA · NH2577
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.
10051 FOXES WAY, King George, VA 22485

Other Names 1

Doing Business AsHeritage Hall - King George

Other Identifiers 3

Medicaid4953002VA
Other180508Anthem Bcbs
Other200515607Federal Black Lung

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 49D0679003

Heritage Hall King George · King George, VA
Active · expires Aug 31, 2026
CLIA Number49D0679003
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorJustine Lewis
Laboratory Phone(540) 775-4000
Laboratory LocationHeritage Hall King George10051 Foxes Way, King George, VA 22485
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 7

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

Speech-Language Pathologist
10051 FOXES WAY
KING GEORGE, VA 22485
Physical Therapist
10051 FOXES WAY
KING GEORGE, VA 22485
Occupational Therapist
10051 FOXES WAY
KING GEORGE, VA 22485
Skilled Nursing Facility
10051 FOXES WAY, BOX 495
KING GEORGE, VA 22485
Speech-Language Pathologist
10051 FOXES WAY
KING GEORGE, VA 22485
Physical Therapy Assistant
10051 FOXES WAY
KING GEORGE, VA 22485
Speech-Language Pathologist
10051 FOXES WAY
KING GEORGE, VA 22485

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 King George Life Care, LLC's NPI number?

The NPI number for King George Life Care, LLC is 1417449422. It was assigned to this organization in the NPPES registry on June 5, 2018. The provider is doing business as Heritage Hall - King George.

Where is King George Life Care, LLC located?

King George Life Care, LLC is located at 10051 Foxes Way, King George, VA 22485. The listed phone number is (540) 775-4000.

What is King George Life Care, LLC's specialty?

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

Does King George Life Care, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D0679003) 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 King George Life Care, LLC was last updated on November 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.