NPIMap

Organization Active NPI

The Village at Rockville, Inc.

  • Skilled Nursing Facility
  • Rockville, MD
National Provider Identifier
1013905579
Registry record updated Feb 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
15036 Issued in MD
Legal business name
THE VILLAGE AT ROCKVILLE, INC.
Practice address
9701 Veirs Dr
Rockville, MD 20850-3462
Phone
(301) 424-9560
Fax
(301) 424-9574
NPI assigned
Oct 10, 2005
Last updated
Feb 19, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael J. Brady, CPA
Title
Chief Financial Officer
Phone
(301) 424-9560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 15036 MD Primary

Addresses

Primary practice location

9701 Veirs Dr
Rockville, MD 20850-3462

Mailing address

9701 Veirs Dr
Rockville, MD 20850-3414
Phone (301) 424-9560

Other identifiers 3

IdentifierTypeStateIssuer
009800100MedicaidMD
155757200MedicaidMD
029831800MedicaidDC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120227000586 MD Part A Provider - Skilled Nursing Facility 8123286804 Practice locations: Rockville, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013905579. Details of each certification follow.

Skilled nursing facility certification: CCN 215125

Legal name
THE VILLAGE AT ROCKVILLE, INC.
Doing business as
THE VILLAGE AT ROCKVILLE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 25, 1980
Last certification
Oct 11, 2024
Beds
160
Ownership / control type
Nonprofit Corporation
Multi-facility organization
National Lutheran Communities & Services
Organization structure
CorporationNon-profit
Incorporated
Dec 13, 1890 in DC
Enrollment address
9701 Veirs Dr
Rockville, MD 20850-3414
Nursing home name
THE VILLAGE AT ROCKVILLE
Affiliated entity
NATIONAL LUTHERAN COMMUNITIES & SERVICES

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Village at RockvilleCCN 215125 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jul 25, 1980
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
160146.5 residents per day on average
Chain
National Lutheran Communities & Services2 facilities in the chain
Penalties (3 years)
1Fines totaling $17,345

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D0693703Village at Rockville, the9701 Veirs Drive, Rockville, MD 20850Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Irene Fraser Individual Other Jan 1, 2016
Richard Mazza Individual Corporate OfficerChief Financial Officer Feb 12, 2018
Kyle S Hreben Individual Corporate DirectorExecutive Director Apr 30, 2018
Donna Burkett Casner Individual Corporate OfficerVice President, Finance Jun 25, 2018
W-2 Managing EmployeeVice President, Finance Jun 25, 2018
Cynthia Walters Individual Corporate OfficerChief Operating Officer Oct 3, 2016
Lawrence Bradshaw Individual Corporate OfficerPresident & Ceo Oct 1, 2009

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455840000000",
    "number": "1013905579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9701 VEIRS DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503414",
            "telephone_number": "301-424-9560",
            "fax_number": "301-424-9574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 VEIRS DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503462",
            "telephone_number": "301-424-9560",
            "fax_number": "301-424-9574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE VILLAGE AT ROCKVILLE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2016-02-19",
        "status": "A",
        "authorized_official_last_name": "BRADY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "301-424-9560",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": "15036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009800100",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155757200",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029831800",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.