NPIMap

Organization Active NPI

Oak Crest Village, Inc.

  • Home Health Agency
  • Parkville, MD
National Provider Identifier
1174558910
Registry record updated Jan 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HH7155 Issued in MD
Legal business name
OAK CREST VILLAGE, INC.
Practice address
8820 Walther Blvd
Attn: Home Health Administrator
Parkville, MD 21234-9025
Phone
(410) 655-1000
Fax
(410) 204-7237
NPI assigned
Jul 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2015

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

Authorized official

Name
James K Walter
Title
Finance Director
Phone
(410) 402-2315

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HH7155 MD Primary

Addresses

Primary practice location

8820 Walther Blvd
Attn: Home Health Administrator
Parkville, MD 21234-9025

Mailing address

8820 Walther Blvd
Attn: Executive Director
Parkville, MD 21234-9025
Phone (410) 655-1000

Other names 1

  • Oak Crest Home Health Agency Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051006000099 MD Part A Provider - Home Health Agency 5991773038 Practice locations: Parkville, MD

Home health agency certification: CCN 217155

Legal name
OAK CREST VILLAGE, INC.
Doing business as
OAK CREST HOME HEALTH AGENCY
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 28, 2006
Last certification
Mar 29, 2021
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Apr 21, 1994 in MD
Enrollment address
8820 Walther Blvd
Att Home Health Administrator
Parkville, MD 21234-9025
HHA Branch

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Oak Crest Village, Inc.CCN 217155
Overall star rating
2.5 of 5
Ownership
Non-Profit
Certified
Feb 28, 2006
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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
21D2019984Oak Crest Village Inc Home Health8820 Walther Blvd, Parkville, MD 21234Certificate of waiverFeb 9, 2027

National Provider Directory

National Provider Directory
Tax ID family
Oak Crest Village Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number 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.

NameRoleSinceShare
Russel N Sharp Individual Corporate DirectorBoard Member Apr 1, 2023
Ian Brown Individual Corporate DirectorBoard Member Apr 1, 2023
National Senior Communities, Inc Organization, Catonsville, MD Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 14, 2021 100%
William Pomeranz Individual Corporate DirectorBoard Member Apr 1, 2025
Michael Roskiewicz Individual Corporate DirectorBoard Member Apr 1, 2019
Patricia Brown Individual Corporate DirectorBoard Member Apr 1, 2022
Stephanie L Reel Individual Corporate OfficerChair & President Oct 27, 2021
Corporate DirectorBoard Member Apr 22, 2013
Neal a Gantert Individual Contracted Managing EmployeeVP, Regional Finance Apr 1, 2018
Corporate OfficerAssistant Treasurer Apr 1, 2018
Mary D Colins Individual Corporate OfficerSecretary Apr 1, 2019
Corporate DirectorBoard Member Apr 1, 2018
Daniel Tyler Individual Corporate OfficerAssistant Treasurer Apr 1, 2025
Eileen G Erstad Individual Corporate OfficerTreasurer Feb 15, 2007
Corporate DirectorBoard Member Feb 15, 2007
Mary Moscato Individual Corporate DirectorBoard Member Apr 1, 2024
Monty C Leonard Individual Corporate OfficerVice Chair & Vice President Apr 1, 2023
Corporate DirectorBoard Member Apr 1, 2022
Daniel Wallick Individual Corporate DirectorBoard Member Apr 1, 2025
Pamela Paulk Individual Corporate DirectorBoard Member Apr 1, 2022
Mark Roussey Individual Contracted Managing EmployeeExecutive Director Mar 1, 2016
Richard Elwood Individual Corporate DirectorBoard Member Apr 1, 2025
Erickson Senior Living LLC Organization, Catonsville, MD LLC Operational/Managerial Control Nov 23, 2020 100%
Christian Sweetser Individual Contracted Managing EmployeeCfo Mar 1, 2022
John Hall Individual Contracted Managing EmployeeVP of Finance Apr 30, 2010
Corporate OfficerAsst. Treasurer Apr 30, 2010
Katherine L Clupper Individual Corporate DirectorBoard Member Apr 1, 2024
Zina Jacque Individual Corporate DirectorBoard Member Apr 1, 2018
Scott R Sawicki Individual Corporate OfficerAssistant Secretary Apr 1, 2024
Mark D Embley Individual Contracted Managing EmployeeVP, Regional Finance Oct 27, 2021
Corporate OfficerAssistant Treasurer Oct 27, 2021
Pamela Stiner Individual Contracted Managing EmployeeVP, Regional Finance Apr 1, 2024
Corporate OfficerAssistant Treasurer Apr 1, 2024

Facilities with the same owner 26

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

View all 26

Practitioners & affiliated clinicians

Affiliated clinicians 6

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": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421798400000",
    "number": "1174558910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8820 WALTHER BLVD",
            "address_2": "ATTN: EXECUTIVE DIRECTOR",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212349025",
            "telephone_number": "410-655-1000",
            "fax_number": "410-204-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8820 WALTHER BLVD",
            "address_2": "ATTN: HOME HEALTH ADMINISTRATOR",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212349025",
            "telephone_number": "410-655-1000",
            "fax_number": "410-204-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK CREST VILLAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2015-01-21",
        "status": "A",
        "authorized_official_last_name": "WALTER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "410-402-2315"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MD",
            "license": "HH7155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oak Crest Home Health Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Parkville, MD

Sources for this page

Verify at the official NPI Registry.