Blue Ridge Nursing, LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

25 Issued in WV

Legal business name

BLUE RIDGE NURSING, LLC

Practice address

1263 S George St
Charles Town, WV 25414-4384

Phone

(304) 725-6575

NPI assigned

Jul 17, 2007

Organization subpart

No

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

Authorized official

Name

Charles R Stoltz

Title

Secretary / Treasurer

Phone

(513) 530-1808

Specialties & licenses 1

Addresses

Other names 1

• Willow Tree Healthcare Center Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Skilled nursing facility certification: CCN 515156

Legal name

BLUE RIDGE NURSING LLC

Doing business as

WILLOW TREE HEALTHCARE CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Oct 10, 1997

Last certification

May 3, 2023

Beds

104

Ownership / control type

Corporation

Multi-facility organization

Communicare

Organization structure

LLCProprietary

Enrollment address

1263 S George St
Charles Town, WV 25414-4384

Nursing home name

WILLOW TREE HEALTHCARE CENTER

Affiliated entity

COMMUNICARE HEALTH

Listed as

Willow Tree Healthcare CenterCCN 515156

Overall star rating

3 of 5

Health inspections

3 of 5

Staffing

2 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Oct 10, 1997

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

104101.2 residents per day on average

Chain

Communicare Health110 facilities in the chain

Penalties (3 years)

1Fines totaling $8,018

Processed by Care Compare on Aug 1, 2026.

Locations

All disclosed owners & managing parties 20

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Vasant Datta, M.D.

  • Family Medicine Physician
  • Hagerstown, MD
  • NPI 1982666913

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 110

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

• 100 Parkway Leasing Co., LLC

  • Skilled Nursing Facility
  • Clarksburg, WV
  • NPI 1689313967

  C.R. Stoltz Irrevocable Trust, I. Rosedale Irrevocable Trust, Ronald S Wilheim 2012 Spousal Trust, Rosedale Family Investment Company, Inc, RRW, LLC, S.L. Rosedale Irrevocable Trust, Wilheim Family Investment Company, Inc.

  CMS ownership
• Autumn Leasing Co., LLC

  • Skilled Nursing Facility
  • Berkeley Springs, WV
  • NPI 1780323055

  C.R. Stoltz Irrevocable Trust, I. Rosedale Irrevocable Trust, Ronald S Wilheim 2012 Spousal Trust, Rosedale Family Investment Company, Inc, RRW, LLC, S.L. Rosedale Irrevocable Trust, Wilheim Family Investment Company, Inc.

  CMS ownership
• BP WV Maplewood Leasing Co., LLC

  • Skilled Nursing Facility
  • Bridgeport, WV
  • NPI 1427762996

  C.R. Stoltz Irrevocable Trust, Health Care Holdings, LLC, I. Rosedale Family Investment Company Inc, I. Rosedale Irrevocable Trust, Ronald S Wilheim 2012 Spousal Trust, Rosedale Family Investment Company, Inc, RRW, LLC, S.L. Rosedale Irrevocable TR

  CMS ownership
• Chesterfield Leasing Co., LLC

  • Skilled Nursing Facility
  • Charleston, WV
  • NPI 1780323063

  C.R. Stoltz Irrevocable Trust, I. Rosedale Irrevocable Trust, Ronald S Wilheim 2012 Spousal Trust, Rosedale Family Investment Company, Inc, RRW, LLC, S.L. Rosedale Irrevocable Trust, Wilheim Family Investment Company, Inc.

  CMS ownership
• Clinic Leasing Co., LLC

  • Skilled Nursing Facility
  • Ivydale, WV
  • NPI 1104530682

  C.R. Stoltz Irrevocable Trust, Health Care Holdings, LLC, I. Rosedale Family Investment Company Inc, I. Rosedale Irrevocable Trust, Ronald S Wilheim 2012 Spousal Trust, Rosedale Family Investment Company, Inc, RRW, LLC, S.L. Rosedale Irrevocable TR

  CMS ownership
• Crestview Terrace Leasing Co., LLC

  • Skilled Nursing Facility
  • Bridgeport, WV
  • NPI 1871232140

  I. Rosedale Irrevocable Trust, Ronald S Wilheim 2012 Spousal Trust, Rosedale Family Investment Company, Inc, S.L. Rosedale Irrevocable Trust

  CMS ownership
• Davisson Run Leasing Co., LLC

  • Skilled Nursing Facility
  • Clarksburg, WV
  • NPI 1336853803

  C.R. Stoltz Irrevocable Trust, Health Care Holdings, LLC, I. Rosedale Family Investment Company Inc, I. Rosedale Irrevocable Trust, Ronald S Wilheim 2012 Spousal Trust, Rosedale Family Investment Company, Inc, RRW, LLC, S.L. Rosedale Irrevocable TR

  CMS ownership
• Days Leasing Co., LLC

  • Skilled Nursing Facility
  • Sutton, WV
  • NPI 1598479065

  C.R. Stoltz Irrevocable Trust, Health Care Holdings, LLC, I. Rosedale Family Investment Company Inc, I. Rosedale Irrevocable Trust, Ronald S Wilheim 2012 Spousal Trust, Rosedale Family Investment Company, Inc, RRW, LLC, S.L. Rosedale Irrevocable TR

  CMS ownership
• Erbacon Leasing Co., LLC

  • Skilled Nursing Facility
  • Cowen, WV
  • NPI 1548974090

  C.R. Stoltz Irrevocable Trust, Health Care Holdings, LLC, I. Rosedale Family Investment Company Inc, I. Rosedale Irrevocable Trust, Ronald S Wilheim 2012 Spousal Trust, Rosedale Family Investment Company, Inc, RRW, LLC, S.L. Rosedale Irrevocable TR

  CMS ownership
• Floral Leasing Co., LLC

  • Skilled Nursing Facility
  • Moundsville, WV
  • NPI 1497494645

  C.R. Stoltz Irrevocable Trust, I. Rosedale Irrevocable Trust, Ronald S Wilheim 2012 Spousal Trust, Rosedale Family Investment Company, Inc, RRW, LLC, S.L. Rosedale Irrevocable Trust, Wilheim Family Investment Company, Inc.

  CMS ownership
• Four Leaf Clover Leasing Co., LLC

  • Skilled Nursing Facility
  • Martinsburg, WV
  • NPI 1972242253

  C.R. Stoltz Irrevocable Trust, I. Rosedale Irrevocable Trust, Ronald S Wilheim 2012 Spousal Trust, Rosedale Family Investment Company, Inc, RRW, LLC, S.L. Rosedale Irrevocable Trust, Wilheim Family Investment Company, Inc.

  CMS ownership
• GB WV Maplewood Leasing Co., LLC

  • Skilled Nursing Facility
  • Lewisburg, WV
  • NPI 1699489153

  C.R. Stoltz Irrevocable Trust, Health Care Holdings, LLC, I. Rosedale Family Investment Company Inc, I. Rosedale Irrevocable Trust, Ronald S Wilheim 2012 Spousal Trust, Rosedale Family Investment Company, Inc, RRW, LLC, S.L. Rosedale Irrevocable TR

  CMS ownership

Practitioners 4

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

• Kolawale Adedeji Oshiyoye, M.D.

  • Urgent Care Clinic/Center
  • Martinsburg, WV
  • NPI 1427362383
  NPD (past)
• Nilay Bhasker Thaker, D.O.

  • Adult Medicine Physician
  • Martinsburg, WV
  • NPI 1124275334
  NPD (past)
• Vasant Datta, M.D.

  • Family Medicine Physician
  • Hagerstown, MD
  • NPI 1982666913
  NPD (past)
• Muhammad K Waseem, MD

  • Internal Medicine Physician
  • Hagerstown, MD
  • NPI 1184665143
  NPD (past)

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Kolawale Adedeji Oshiyoye, M.D.

  • Urgent Care Clinic/Center
  • Martinsburg, WV
  • NPI 1427362383

  Nursing home

  Care Compare affiliation
• Nilay Bhasker Thaker, D.O.

  • Adult Medicine Physician
  • Martinsburg, WV
  • NPI 1124275334

  Nursing home

  Care Compare affiliation
• Vasant Datta, M.D.

  • Family Medicine Physician
  • Hagerstown, MD
  • NPI 1982666913

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1346449451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10123 ALLIANCE RD",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452424887",
            "telephone_number": "513-530-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1263 S GEORGE ST",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254144384",
            "telephone_number": "304-725-6575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE NURSING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "STOLTZ",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SECRETARY / TREASURER",
        "authorized_official_telephone_number": "513-530-1808"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "WV",
            "license": "25",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Willow Tree Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole Beckner, OTR/L
• Christina Benson
• Nicole Elizabeth Berryhill
• Beyond Limits Mobile Outpatient Therapy, LLC
• Matthew James Blazek, BCBA
• Kayla Marie Boggess, SLP
• Carolynn Boone, REGISTERED NURSE
• Christina Bouchoc
• Raymond Bouchoc
• Brittany Russell, LLC

• All providers in Charles Town, WV
• Nursing Facility/Intermediate Care Facility in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.

Verify at the official NPI Registry.