Active NPI
Worthington Christian Village, Inc.
- Nursing Facility/Intermediate Care Facility
- Columbus, OH
National Provider Identifier
1194722744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- License
- 1838
- Legal business name
- WORTHINGTON CHRISTIAN VILLAGE, INC.
- Practice address
- 165 Highbluffs Blvd
Columbus, OH 43235-1484 - Phone
- (614) 846-6076
- Fax
- (614) 842-9541
- NPI assigned
- Jun 28, 2005
- 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
- Mr. Randy Richardson
- Title
- Executive Director
- Phone
- (614) 846-6076
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 1838R | OH | |
| Nursing Facility/Intermediate Care Facility | 313M00000X | 1838 | OH | Primary |
| Skilled Nursing Facility | 314000000X | 1838 | OH |
Addresses
Primary practice location
165 Highbluffs Blvd
Columbus, OH 43235-1484
Mailing address
165 Highbluffs Blvd
Columbus, OH 43235-1484
Phone (614) 846-6076
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0619352 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120405000191 | OH | Part A Provider - Skilled Nursing Facility | 3375704075 | Practice locations: Columbus, OH |
Skilled nursing facility certification: CCN 365671
- Legal name
- WORTHINGTON CHRISTIAN VILLAGE, INC.
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Mar 3, 1986
- Last certification
- Mar 21, 2024
- Beds
- 40
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Incorporated
- Jun 2, 1977 in OH
- Enrollment address
- 165 Highbluffs Blvd
Columbus, OH 43235-1484 - Nursing home name
- WORTHINGTON CHRISTIAN VILLAGE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Worthington Christian Village
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Mar 3, 1986
- Medicare certification status
- Active
- Certified beds
- 40
- Penalties (3 years)
- 1
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 |
|---|---|---|---|
| 36D0330536 | Worthington Christian Village Inc | Certificate of waiver | Jun 28, 2027 |
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Patrick Mauger | Corporate Officer | Jan 1, 2021 | |
| W-2 Managing Employee | Jan 1, 2021 | ||
| Ginger Brady | W-2 Managing Employee | Oct 8, 2017 | |
| Mike Stumpf | Corporate Director | Jun 1, 2020 | |
| Charles William Thomas | Corporate Director | Jun 1, 2016 | |
| Michael Willis | W-2 Managing Employee | Aug 4, 2015 | |
| Hugh Snepp | Corporate Director | Jun 1, 2022 | |
| William Lavely | Corporate Director | Jun 1, 2014 | |
| Marcia Hardy | Corporate Director | Jun 1, 2020 | |
| Daniel Spears | Corporate Officer | Jun 1, 2021 | |
| Henry Norris | Corporate Director | Jun 1, 2013 | |
| Kathy Breen | Corporate Director | Jun 1, 2021 | |
| Lynn Borton | Corporate Director | Jun 1, 2015 | |
| Robert Spengler | Corporate Officer | Jun 1, 2021 |
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Westerville, OH
- NPI 1801865670
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119916800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1194722744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "165 HIGHBLUFFS BLVD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432351484",
"telephone_number": "614-846-6076",
"fax_number": "614-842-9541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165 HIGHBLUFFS BLVD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432351484",
"telephone_number": "614-846-6076",
"fax_number": "614-842-9541"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WORTHINGTON CHRISTIAN VILLAGE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-06-28",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "RICHARDSON",
"authorized_official_first_name": "RANDY",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "614-846-6076",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "OH",
"license": "1838R",
"primary": false
},
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "OH",
"license": "1838",
"primary": true
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "OH",
"license": "1838",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0619352",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.