Active NPI
Graceworks Lutheran Services
- Skilled Nursing Facility
- Dayton, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 0632N
- Legal business name
- GRACEWORKS LUTHERAN SERVICES
- Practice address
- 6451 Far Hills Ave
Dayton, OH 45459-2725 - Phone
- (937) 433-2110
- NPI assigned
- Sep 29, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Robert A Reichard, CPA
- Title
- Vice President, Finance
- Phone
- (937) 436-6865
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0632N | OH | Primary |
Addresses
Primary practice location
6451 Far Hills Ave
Dayton, OH 45459-2725
Mailing address
6451 Far Hills Ave
Dayton, OH 45459-2725
Phone (937) 433-2110
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0684255 | Medicaid | OH |
Other names 1
- Bethany Village
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100423000113 | OH | Part A Provider - Skilled Nursing Facility | 4981731999 | Practice locations: Dayton, OH |
Skilled nursing facility certification: CCN 365493
- Legal name
- GRACEWORKS LUTHERAN SERVICES
- Doing business as
- BETHANY VILLAGE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 1, 1980
- Last certification
- Oct 27, 2022
- Beds
- 227
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Incorporated
- May 24, 1926 in OH
- Enrollment address
- 6451 Far Hills Ave
Dayton, OH 45459-2725 - Nursing home name
- BETHANY VILLAGE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Bethany Village
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Jun 1, 1980
- Medicare certification status
- Active
- Certified beds
- 227
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D2268477 | Bethany Village | Certificate of waiver | Sep 12, 2026 |
National Provider Directory
National Provider Directory- Tax ID family
- Lutheran Social Service
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Assisted Living Facility
- Centerville, OH
- NPI 1558188607
Member organizations 1
Organizations listed as members of this organization in the National Provider Directory.
Ownership & related parties
All disclosed owners & managing parties 25
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Mari E Townsend | Corporate Director | May 14, 2019 | |
| John Mittermaier | Corporate Director | May 11, 2021 | |
| Amy M Houghtling | Corporate Director | Apr 8, 2025 | |
| Meenakshi C Patel | Operational/Managerial Control | Apr 1, 2010 | |
| Adp of the SNF | Feb 7, 2025 | ||
| Jessica Jordan | Corporate Director | Apr 8, 2025 | |
| Eugene Long | Corporate Director | Jun 2, 2020 | |
| Dan Driskell | Corporate Director | May 11, 2021 | |
| Ann Schemmel | Corporate Director | Apr 8, 2025 | |
| Lora a. Cox-Vance | Corporate Director | Apr 18, 2023 | |
| Rita S Bair | Corporate Director | Apr 16, 2024 | |
| Dawn Barhorst | Corporate Officer | Jan 1, 2020 | |
| Robert Reichard | Corporate Officer | Nov 7, 2022 | |
| Lauren Coyle | Operational/Managerial Control | Mar 19, 2021 | |
| Adp of the SNF | Feb 7, 2025 | ||
| Ann S Baines | Corporate Director | Apr 16, 2024 | |
| Graceworks Lutheran Services | Operational/Managerial Control | Apr 1, 2010 | 100% |
| Kevin Nels | Corporate Director | Aug 8, 2017 | |
| Teresa a Quick | Corporate Director | May 14, 2019 | |
| Mary G Adams | Corporate Director | May 8, 2018 | |
| Jackie Anne D'Aurora | Corporate Officer | May 10, 2016 | |
| Mark S Feuer | Corporate Director | May 10, 2016 | |
| Mark Chilson | Corporate Director | Jun 2, 2020 | |
| Twana S Jones | Corporate Director | May 8, 2018 | |
| Mose J Richardson | Corporate Director | Apr 18, 2023 | |
| Linda Ashworth | Corporate Director | Apr 8, 2025 | |
| Judy Budi | Corporate Officer | Apr 1, 2010 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Geriatric Medicine (Internal Medicine) Physician
- Centerville, OH
- NPI 1568458362
Adp of the SNF, Operational/Managerial Control
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Bethany Village Home Health Care | Home health agency | 5% Or Greater Indirect Ownership Interest (100%) Operational/Managerial Control (100%) |
Jun 27, 2008 Jun 27, 2008 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Home Health Agency
- Dayton, OH
- NPI 1265768956
5% Or Greater Indirect Ownership Interest, Operational/Managerial Control
Facilities with the same owner 1
Facilities that share an organizational owner with 5% or greater ownership or operational control.
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Geriatric Medicine (Family Medicine) Physician
- Oakwood, OH
- NPI 1952384505
-
- Geriatric Medicine (Internal Medicine) Physician
- Centerville, OH
- NPI 1568458362
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Family Medicine) Physician
- Oakwood, OH
- NPI 1952384505
Nursing home
-
- Geriatric Medicine (Internal Medicine) Physician
- Centerville, OH
- NPI 1568458362
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1711324800000",
"number": "1033201611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6451 FAR HILLS AVE",
"city": "DAYTON",
"state": "OH",
"postal_code": "454592725",
"telephone_number": "937-433-2110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6451 FAR HILLS AVE",
"city": "DAYTON",
"state": "OH",
"postal_code": "454592725",
"telephone_number": "937-433-2110"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRACEWORKS LUTHERAN SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-29",
"last_updated": "2024-03-25",
"certification_date": "2024-03-25",
"status": "A",
"authorized_official_last_name": "REICHARD",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "VICE PRESIDENT, FINANCE",
"authorized_official_telephone_number": "937-436-6865",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "CPA"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "OH",
"license": "0632N",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0684255",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Bethany Village",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.