Organization Active NPI

Our Lady of the Valley, Inc.

  • Skilled Nursing Facility
  • Roanoke, VA
National Provider Identifier
1245330299
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH2650 Issued in VA
Legal business name
OUR LADY OF THE VALLEY, INC.
Practice address
650 N Jefferson St
Roanoke, VA 24016-1427
Phone
(540) 345-5111
Fax
(540) 985-6561
NPI assigned
Sep 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Authorized official

Name
Mrs. Lee Blair
Title
President
Phone
(540) 989-9604

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH2650 VA Primary

Addresses

Primary practice location

650 N Jefferson St
Roanoke, VA 24016-1427

Mailing address

650 N Jefferson St
Roanoke, VA 24016-1427
Phone (540) 345-5111

Other identifiers 1

IdentifierTypeStateIssuer
4953567MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040211000513 VA Part A Provider - Skilled Nursing Facility 6103710041 Practice locations: Roanoke, VA

Skilled nursing facility certification: CCN 495357

Legal name
OUR LADY OF THE VALLEY, INC.
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 2001
Last certification
Aug 25, 2023
Beds
70
Ownership / control type
Church Related
Organization structure
CorporationProprietary
Incorporated
Nov 26, 1988 in VA
Enrollment address
650 N Jefferson St
Roanoke, VA 24016-1427
Nursing home name
OUR LADY OF THE VALLEY

Care Compare: Nursing home

Medicare Care Compare
Listed as
Our Lady Of The ValleyCCN 495357
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Church related
Certified
Oct 1, 2001
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7063.6 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
49D0231482Our Lady of the Valley650 N Jefferson St, Roanoke, VA 24016Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Denise White Individual Operational/Managerial Control Nov 4, 2011
Mary McNichols Individual W-2 Managing Employee Nov 26, 1988
David Rawlings Individual Operational/Managerial Control Nov 4, 2011
OtherVice President of Operations Dec 5, 2021 50%

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740441600000",
    "number": "1245330299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 N JEFFERSON ST",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240161427",
            "telephone_number": "540-345-5111",
            "fax_number": "540-985-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 N JEFFERSON ST",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240161427",
            "telephone_number": "540-345-5111",
            "fax_number": "540-985-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF THE VALLEY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "540-989-9604",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "VA",
            "license": "NH2650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4953567",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.