Active NPI
General German Aged Peoples Home of Baltimore
- Skilled Nursing Facility
- Towson, MD
National Provider Identifier
1205239688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- GENERAL GERMAN AGED PEOPLES HOME OF BALTIMORE
- Practice address
- 800 Southerly Rd
Towson, MD 21286-8403 - Phone
- (410) 339-6000
- Fax
- (410) 583-8786
- NPI assigned
- Sep 30, 2014
- 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
- Roland Devasher
- Title
- V.P. of Finance & Administration
- Phone
- (410) 339-6013
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 03AL618-H | MD | |
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
800 Southerly Rd
Towson, MD 21286-8403
Mailing address
800 Southerly Rd
Towson, MD 21286-8403
Phone (410) 339-6000
Other names 1
- Edenwald
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201019003103 | MD | Part A Provider - Skilled Nursing Facility | 3375963085 | Practice locations: Towson, MD |
Skilled nursing facility certification: CCN 215372
- Legal name
- GENERAL GERMAN AGED PEOPLES HOME OF BALTIMORE
- Doing business as
- EDENWALD
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF (Medicare) only
- Participating since
- Aug 5, 2022
- Last certification
- Jun 17, 2022
- Beds
- 70
- Ownership / control type
- Corporation
- Organization structure
- Corporation
- Incorporated
- Jun 8, 1881 in MD
- Enrollment address
- 800 Southerly Road
Towson, MD 21286-8403 - Nursing home name
- EDENWALD
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Edenwald
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare
- Ownership
- For profit - Corporation
- Certified
- Aug 5, 2022
- Medicare certification status
- Active
- Certified beds
- 70
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 |
|---|---|---|---|
| 21D2201430 | Edenwald | Certificate of waiver | Nov 19, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 29
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 |
|---|---|---|---|
| Frank Palumbo | Corporate Officer | Jan 1, 2025 | |
| Aira Bautista-O'Donnell | Operational/Managerial Control | Apr 5, 2024 | |
| Adp of the SNF | Jul 17, 2025 | ||
| Andri Purkanto | Corporate Officer | Jan 1, 2025 | |
| Adp of the SNF | Apr 4, 2019 | ||
| Lori Wolford | Operational/Managerial Control | Apr 5, 2024 | |
| Candace Richardson | Corporate Officer | Jan 1, 2025 | |
| Adp of the SNF | Mar 1, 2016 | ||
| Adp of the SNF | Jan 2, 2023 | ||
| Debra S Wertheimer | Corporate Officer | Jan 1, 2025 | |
| Tim Wessel | Corporate Officer | Jan 1, 2025 | |
| Adp of the SNF | May 2, 2005 | ||
| Shanetrica Chester | Operational/Managerial Control | Mar 31, 2025 | |
| Adp of the SNF | Mar 31, 2025 | ||
| Cory Silkman | Corporate Officer | Jan 1, 2025 | |
| Astrid Wexler | Corporate Officer | Jan 1, 2025 | |
| Remi Ackerman | Corporate Officer | Feb 28, 2025 | |
| Operational/Managerial Control | Feb 28, 2025 | ||
| Adp of the SNF | Aug 8, 2019 | ||
| Adp of the SNF | Mar 31, 2005 | ||
| Adp of the SNF | May 6, 2005 | ||
| Adp of the SNF | May 7, 2005 | ||
| Adp of the SNF | Jan 14, 2023 | ||
| Adp of the SNF | Dec 14, 2021 | ||
| Mark Beggs | Corporate Officer | Dec 1, 2022 | |
| Adp of the SNF | Apr 14, 2005 | ||
| Vince Nesline | Corporate Officer | Dec 20, 2020 | |
| Larry Cook | Corporate Officer | Jan 1, 2025 | |
| Scott Ensor | Corporate Officer | Jan 1, 2025 | |
| Adp of the SNF | Oct 24, 2021 | ||
| Andrew Moore | Corporate Officer | Jan 1, 2025 | |
| Adp of the SNF | Dec 4, 2023 |
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Family Medicine) Physician
- Baltimore, MD
- NPI 1245259902
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412035200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1697587200000",
"number": "1205239688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 SOUTHERLY RD",
"city": "TOWSON",
"state": "MD",
"postal_code": "212868403",
"telephone_number": "410-339-6000",
"fax_number": "410-583-8786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 SOUTHERLY RD",
"city": "TOWSON",
"state": "MD",
"postal_code": "212868403",
"telephone_number": "410-339-6000",
"fax_number": "410-583-8786"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GENERAL GERMAN AGED PEOPLES HOME OF BALTIMORE",
"organizational_subpart": "NO",
"enumeration_date": "2014-09-30",
"last_updated": "2023-10-18",
"certification_date": "2023-10-18",
"status": "A",
"authorized_official_last_name": "DEVASHER",
"authorized_official_first_name": "ROLAND",
"authorized_official_title_or_position": "V.P. OF FINANCE & ADMINISTRATION",
"authorized_official_telephone_number": "410-339-6013"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "MD",
"license": "03AL618-H",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Edenwald",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Edenwald",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Towson, MD
- Marcia Gekowski, M.D.
- Beth Cohen Geller, P.D.
- Gemikings Healthservices Inc
- Crystal Ann Gempko, PA-C
- Aysenur Genc, DMD
- Genesis Eldercare Physician Services LLC
- Genesis Eldercare Physician Services LLC
- Genesis Eldercare Physician Services LLC
- Genesis Eldercare Physician Services LLC
- Genesis Rehab Services
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.