NPIMap

Organization Active NPI

The Grand Lodge of Ancient Free and Accepted Masons of Maryland

  • Nursing Facility/Intermediate Care Facility
  • Cockeysville, MD
National Provider Identifier
1033264973
Registry record updated Jun 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
03023 Issued in MD
Legal business name
THE GRAND LODGE OF ANCIENT FREE AND ACCEPTED MASONS OF MARYLAND
Doing business as
Maryland Masonic Homes
Practice address
300 International Cir
Cockeysville, MD 21030-1300
Phone
(410) 527-1111
Fax
(410) 527-1379
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2014

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

Authorized official

Name
Mrs. Paula Lee O Neill, NURSING HOME ADMIN
Title
Executive Director
Phone
(410) 527-1111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 03023 MD Primary

Addresses

Primary practice location

300 International Cir
Cockeysville, MD 21030-1300

Mailing address

300 International Cir
Cockeysville, MD 21030-1300
Phone (410) 527-1111

Other names 1

  • Maryland Masonic Homes Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140620000073 MD Part A Provider - Skilled Nursing Facility 6103040803 Practice locations: Cockeysville, MD

Skilled nursing facility certification: CCN 215361

Legal name
THE GRAND LODGE OF ANCIENT FREE AND ACCEPTED MASONS OF MARYLAND
Doing business as
MARYLAND MASONIC HOMES LTD
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 23, 2014
Last certification
May 13, 2021
Beds
88
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 8, 1822 in MD
Enrollment address
300 International Cir
Cockeysville, MD 21030-1300
Nursing home name
MARYLAND MASONIC HOMES LTD

Care Compare: Nursing home

Medicare Care Compare
Listed as
Maryland Masonic Homes LTDCCN 215361 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Sep 23, 2014
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8868.0 residents per day on average
Penalties (3 years)
1Fines totaling $16,420

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Maryland Masonic Homes2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Robert W Reynolds Individual Corporate DirectorBoard Member Nov 20, 2016
David R Sandy Individual Corporate DirectorBoard of Trustees Member Jul 1, 2014
Charles a Beckhardt Individual Corporate DirectorBoard Member Nov 20, 2016
Kostas Vourvoulas Individual Corporate OfficerGrand Master Nov 20, 2016
Corporate DirectorCeo Nov 20, 2016
Operational/Managerial ControlGrand Master/Ceo Nov 20, 2016
Kenneth R Taylor Individual Corporate DirectorBoard Member Nov 20, 2016
Operational/Managerial ControlGrand Secretary/Board Member Nov 20, 2016
Stuart J Cordish Individual Corporate DirectorBoard Member Nov 20, 2016
Carl W Lee Individual Corporate DirectorBoard of Trustees Member Jul 1, 2014
Randall L Watson Individual Corporate DirectorBoard Member/Grand Treasury Nov 20, 2016
Maryland Masonic Homes,LTD Organization, Cockeysville, MD Corporation, Non-profit Operational/Managerial Control Jul 1, 2018 100%
Charles E Warns Individual Corporate DirectorBoard of Trustees Member Jul 1, 2014
Tammie Houck Individual W-2 Managing EmployeeAdministrator Delegated Official Apr 27, 2015
Operational/Managerial ControlAdministrator, Delegated Officia Apr 27, 2014
Richard P Naegele Individual Corporate OfficerDeputy Grand Master Nov 20, 2016
John E Herold Individual Corporate DirectorBoard Member Nov 20, 2016

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403222400000",
    "number": "1033264973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 INTERNATIONAL CIR",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210301300",
            "telephone_number": "410-527-1111",
            "fax_number": "410-527-1379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 INTERNATIONAL CIR",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210301300",
            "telephone_number": "410-527-1111",
            "fax_number": "410-527-1379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GRAND LODGE OF ANCIENT FREE AND ACCEPTED MASONS OF MARYLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2014-06-20",
        "status": "A",
        "authorized_official_last_name": "O NEILL",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "410-527-1111",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NURSING HOME ADMIN"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MD",
            "license": "03023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maryland Masonic Homes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cockeysville, MD

Sources for this page

Verify at the official NPI Registry.