Wells Nursing Home, Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1702300N Issued in NY

Legal business name

WELLS NURSING HOME, INC

Practice address

201 W Madison Ave
Johnstown, NY 12095-2806

Phone

(518) 762-4548

Fax

(518) 736-1570

NPI assigned

Jan 22, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Neal E. Vanslyke

Title

Administrator

Phone

(518) 762-4546

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Wells House Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Skilled nursing facility certification: CCN 335314002

Legal name

WELLS NURSING HOME INC

Organization structure

CorporationNon-profit

Incorporated

Nov 17, 1967 in NY

Enrollment address

201 W Madison Ave
Johnstown, NY 12095-2806

Nursing home name

WELLS NURSING HOME INC

Other NPIs with the same Medicare PAC ID 1

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

• Wells Nursing Home Inc.

  • Skilled Nursing Facility
  • Johnstown, NY
  • NPI 1518010875

  8628243391

  Same PAC ID

All disclosed owners & managing parties 12

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bryan E Kurtz, MD

  • Emergency Medicine Physician
  • Saratoga Springs, NY
  • NPI 1790710069
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245384189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W MADISON AVE",
            "city": "JOHNSTOWN",
            "state": "NY",
            "postal_code": "120952806",
            "telephone_number": "518-762-4548",
            "fax_number": "518-736-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W MADISON AVE",
            "city": "JOHNSTOWN",
            "state": "NY",
            "postal_code": "120952806",
            "telephone_number": "518-762-4548",
            "fax_number": "518-736-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLS NURSING HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VANSLYKE",
        "authorized_official_first_name": "NEAL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "518-762-4546",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "1702300N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0039494849",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUECROSS",
            "identifier": "007964",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD OF NENY",
            "identifier": "GRP490087001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "1797",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "43015",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wells House Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Holly B Walrath
• Todd Walton, O.D.
• Sally A Webber, RN
• Wells Nursing Home Inc.
• Wells Nursing Home Inc.
• Lori Joan Welsher, PT
• Lisa Westerling
• Willing Helpers Home for Women Inc.
• Dale Shirley Woods, SPHN
• Dennis Walter Woods, B.S

• Physical Therapist in Johnstown, NY
• Providers in Johnstown, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.