Active NPI
Montgomery General Elderly Care Center, Inc.
- Skilled Nursing Facility
- Montgomery, WV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 106
- Legal business name
- MONTGOMERY GENERAL ELDERLY CARE CENTER, INC.
- Practice address
- 501 Adams St
Montgomery, WV 25136-2124 - Phone
- (304) 442-7479
- NPI assigned
- Sep 21, 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
- Ursula Perry, NHA
- Title
- Administrator
- Phone
- (304) 442-1248
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 106 | WV | Primary |
Addresses
Primary practice location
501 Adams St
Montgomery, WV 25136-2124
Mailing address
501 Adams St
Montgomery, WV 25136-2124
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0004199000 | Medicaid | WV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120517000058 | WV | Part A Provider - Skilled Nursing Facility | 6608039359 | Practice locations: Montgomery, WV |
Skilled nursing facility certification: CCN 515152
- Legal name
- MONTGOMERY GENERAL ELDERLY CARE CENTER, INC.
- Doing business as
- MONTGOMERY REHAB AND NURSING
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Mar 17, 1997
- Last certification
- Oct 24, 2024
- Beds
- 60
- Ownership / control type
- Corporation
- Organization structure
- Corporation
- Incorporated
- Apr 8, 1985 in WV
- Enrollment address
- 501 Adams Street
Montgomery, WV 25136-1010 - Nursing home name
- MONTGOMERY GENERAL ELDERLY CARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Montgomery General Elderly Care
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Mar 17, 1997
- Medicare certification status
- Active
- Certified beds
- 60
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 |
|---|---|---|---|
| 51D0672265 | Montgomery General Elderly Care Ctr | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryLocations
501 Adams St
Montgomery, WV 25136
Phone (304) 442-2469
Ownership & related parties
All disclosed owners & managing parties 9
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 |
|---|---|---|---|
| Barbara Crist | Corporate Director | Mar 19, 2012 | |
| Sammar Atassi | Operational/Managerial Control | Jan 1, 2010 | |
| Adp of the SNF | Feb 26, 2025 | ||
| Patsy C Tucker | Corporate Director | Mar 19, 2012 | |
| Raleigh L Collins | Corporate Director | Mar 19, 2012 | |
| Michael Taylor | Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Jan 1, 2025 | ||
| Donald L Smith | Corporate Director | Mar 19, 2012 | |
| Deborah a a Hill | Corporate Officer | Mar 25, 2022 | |
| Corporate Director | Mar 25, 2022 | ||
| Sherri L Murray | Corporate Officer | Mar 19, 2012 | |
| Operational/Managerial Control | Mar 25, 2022 | ||
| Ghassan Y Dagher | Corporate Director | Mar 19, 2012 |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Sleep Medicine (Internal Medicine) Physician
- Montgomery, WV
- NPI 1396845137
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Sleep Medicine (Internal Medicine) Physician
- Montgomery, WV
- NPI 1396845137
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Sleep Medicine (Internal Medicine) Physician
- Montgomery, WV
- NPI 1396845137
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1675296000000",
"number": "1053410985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 ADAMS ST",
"city": "MONTGOMERY",
"state": "WV",
"postal_code": "251362124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 ADAMS ST",
"city": "MONTGOMERY",
"state": "WV",
"postal_code": "251362124",
"telephone_number": "304-442-7479"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MONTGOMERY GENERAL ELDERLY CARE CENTER, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-21",
"last_updated": "2023-02-02",
"certification_date": "2023-02-02",
"status": "A",
"authorized_official_last_name": "PERRY",
"authorized_official_first_name": "URSULA",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "304-442-1248",
"authorized_official_credential": "NHA"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "WV",
"license": "106",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0004199000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Montgomery, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.