NPIMap

Organization Active NPI

Presbyterian Retirement Communities, Inc.

  • Skilled Nursing Facility
  • Winter Park, FL
National Provider Identifier
1104861871
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
SNF1612096 Issued in FL
Legal business name
PRESBYTERIAN RETIREMENT COMMUNITIES, INC.
Practice address
1111 S Lakemont Ave
Winter Park, FL 32792-5469
Phone
(407) 647-4083
Fax
(407) 645-4407
NPI assigned
Jun 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Henry T Keith
Title
Chief Financial Officer
Phone
(407) 839-5050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X SNF1612096 FL Primary

Addresses

Primary practice location

1111 S Lakemont Ave
Winter Park, FL 32792-5469

Mailing address

80 W Lucerne Cir
Orlando, FL 32801-3779
Phone (407) 839-5050

Other identifiers 1

IdentifierTypeStateIssuer
1222930001OtherFLDMERC SUPPLIER NUMBER

Other names 1

  • Winter Park Towers Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091209000535 FL Part A Provider - Skilled Nursing Facility 1557400348 Practice locations: Winter Park, FL

Skilled nursing facility certification: CCN 105879

Legal name
PRESBYTERIAN RETIREMENT COMMUNITIES, INC.
Doing business as
WESTMINSTER WINTER PARK
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 3, 1995
Last certification
Oct 31, 2024
Beds
80
Ownership / control type
Church Related
Multi-facility organization
Westminster Communities of Florida
Organization structure
CorporationNon-profit
Incorporated
Dec 31, 1954 in FL
Enrollment address
1111 S Lakemont Ave
Winter Park, FL 32792-5469
Nursing home name
WESTMINSTER WINTER PARK
Affiliated entity
WESTMINSTER COMMUNITIES OF FLORIDA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Westminster Winter ParkCCN 105879
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Church related
Certified
Mar 3, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8075.1 residents per day on average
Chain
Westminster Communities of Florida9 facilities in the chain
Penalties (3 years)
1Fines totaling $65,683

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
10D0713356Westminster Winter Park1111 S Lakemont Ave #101, Winter Park, FL 32792Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Presbyterian Retirement Communities Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

1111 S Lakemont Ave
Ste 101
Winter Park, FL 32792

Networks

  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)
  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
John Hillenmeyer Individual Corporate DirectorVolunteer Board Member Aug 19, 2009
Henry Keith Individual Corporate OfficerCfo Jan 1, 1994 100%
John Ramsey Individual Corporate DirectorVolunteer Board Member Jan 1, 2020
Stephen Dye Individual Corporate DirectorVolunteer Board Member Aug 19, 2009
Garry Hennis Individual Corporate OfficerCoo & Evp Jan 1, 2025
Mary Ellen Early Individual Corporate DirectorDirector Jan 1, 2025
Donald D Doddridge Individual Corporate DirectorChairman Jan 1, 2025
William Hull Individual Corporate DirectorDirector Jan 1, 2024
Megan Faubel Individual Corporate OfficerSecretary Jan 1, 2025
Jeffrey Mock Individual Corporate DirectorVolunteer Board Member Jan 1, 2020
William Bell Individual Corporate DirectorVolunteer Board Member Aug 19, 2009
Kristin Kutac Individual Corporate DirectorDirector Jan 1, 2024
John Debevoise Individual Corporate DirectorVolunteer Board Member Jan 1, 2020
Gary Grayson Lehman Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF May 27, 2025
Carlen Maddux Individual Corporate DirectorVolunteer Board Member Jan 1, 2020
Westminster Services Inc Organization, Orlando, FL Corporation, Management services company, Non-profit, Chain home office Operational/Managerial Control Jan 1, 1966 100%
Joel Kuriakose Individual Operational/Managerial Control May 6, 2019
Adp of the SNF Apr 14, 2025
Linda Shelley Individual Corporate DirectorVolunteer Board Member Jan 1, 2020

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Westminster Baldwin ParkOrlando, FL, CCN 106118 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 29, 2014

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 6

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 9

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": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104861871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 W LUCERNE CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328013779",
            "telephone_number": "407-839-5050",
            "fax_number": "407-849-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 S LAKEMONT AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327925469",
            "telephone_number": "407-647-4083",
            "fax_number": "407-645-4407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN RETIREMENT COMMUNITIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KEITH",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "407-839-5050",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1612096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC SUPPLIER NUMBER",
            "identifier": "1222930001",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Winter Park Towers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.