Organization Active NPI

Montgomery General Elderly Care Center, Inc.

  • Skilled Nursing Facility
  • Montgomery, WV
National Provider Identifier
1053410985
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
106 Issued in WV
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

Updated by the provider on Feb 2, 2023

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0004199000MedicaidWV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
CorporationNon-profit
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 CareCCN 515152
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Mar 17, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6058.2 residents per day on average

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
51D0672265Montgomery General Elderly Care Ctr501 Adams Street, Montgomery, WV 25136Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

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.

NameRoleSinceShare
Barbara Crist Individual Corporate DirectorBoard Member Mar 19, 2012
Sammar Atassi Individual Operational/Managerial Control Jan 1, 2010
Adp of the SNF Feb 26, 2025
Patsy C Tucker Individual Corporate DirectorBoard Member Mar 19, 2012
Raleigh L Collins Individual Corporate DirectorBoard Member Mar 19, 2012
Michael Taylor Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Donald L Smith Individual Corporate DirectorBoard Member Mar 19, 2012
Deborah a a Hill Individual Corporate Officer Mar 25, 2022
Corporate Director Mar 25, 2022
Sherri L Murray Individual Corporate OfficerCfo Mar 19, 2012
Operational/Managerial Control Mar 25, 2022
Ghassan Y Dagher Individual Corporate DirectorBoard Member 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.

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 1

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": "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

Verify at the official NPI Registry.