Holly Manor Nursing Home – Skilled Nursing Facility, NPI 1235886607

Holly Manor Nursing Home is a healthcare provider. based in Farmville, Virginia. specializing in Skilled Nursing Facility. The NPI Number for Holly Manor Nursing Home is 1235886607

Main info

Organization
Name
Holly Manor Nursing Home
NPI
1235886607
Phone
Not provided
Address
2003 COBB ST
Authorized Official
JOSEPH LIEBERMAN VICE PRESIDENT OF COST CONTAINMENT
Enumeration Date
7 March 2022
Last Update Date
12 April 2026
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness90
Years active:4State licenses:0Digital endpoints

Provider Addresses for Holly Manor Nursing Home

  • 2003 COBB ST

    FARMVILLE, VA 239012603

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-07-21

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20220721003803OSkilled Nursing FacilityVATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 23901)

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Reviews

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Frequently asked questions

What NPI should I save for Holly Manor Nursing Home?
Save NPI 1235886607 if you need a stable reference for Holly Manor Nursing Home.
Is Holly Manor Nursing Home currently active in the NPI registry?
CMS-published data lists Holly Manor Nursing Home as an active registrant.
Does Holly Manor Nursing Home list a primary specialty?
If you are matching referrals, note Skilled Nursing Facility for Holly Manor Nursing Home. Clinical services aligned with this taxonomy classification.
Where does public data place Holly Manor Nursing Home?
The snapshot lists Farmville, Virginia for Holly Manor Nursing Home; download NPPES for the complete set.
What if Farmville, Virginia seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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