NPIMap

Organization Active NPI

Gerry Homes Inc

  • Skilled Nursing Facility
  • Jamestown, NY
National Provider Identifier
1366448706
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0602310N Issued in NY
Legal business name
GERRY HOMES INC
Practice address
150 Prather Ave
Jamestown, NY 14701-6710
Phone
(716) 488-1921
Fax
(716) 484-2933
NPI assigned
Jun 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Authorized official

Name
Lisa Haglund
Title
Ceo
Phone
(716) 488-1921

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0602310N NY Primary

Addresses

Primary practice location

150 Prather Ave
Jamestown, NY 14701-6710

Mailing address

PO Box 360
Gerry, NY 14740-0360
Phone (716) 985-6813

Other identifiers 2

IdentifierTypeStateIssuer
00030010001OtherNYSENIOR CHOICE PROVIDER
01520369MedicaidNY

Other names 1

  • Heritage Park Rehab & Skilled Nursing Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111227000580 NY Part A Provider - Skilled Nursing Facility 9335130202 Practice locations: Jamestown, NY

Skilled nursing facility certification: CCN 335142001

Legal name
GERRY HOMES INC
Doing business as
HERITAGE PARK REHAB & SKILLED NURSING
Organization structure
CorporationNon-profit
Enrollment address
150 Prather Ave
Jamestown, NY 14701-6710
Nursing home name
HERITAGE PARK REHAB & SKILLED NURSING
Affiliated entity
HERITAGE MINISTRIES

Other NPIs with the same Medicare PAC ID 1

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

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
33D0890057Heritage Park Rehab and Skilled Nursing150 Prather Avenue, Jamestown, NY 14701Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Pamela Noll Individual Corporate DirectorBoard Member Nov 25, 2024
Lisa Haglund Individual Corporate OfficerCeo May 11, 2020
Operational/Managerial Control May 11, 2020
Albert J Persia Individual Operational/Managerial Control Jul 24, 2023
Adp of the SNF Jul 24, 2023
Mary Ann Spanos Individual Corporate DirectorBoard Member Nov 25, 2024
Peter Michael Stark Individual Corporate DirectorBoard Member Nov 25, 2024
Jessica Burkhouse Individual Operational/Managerial Control Jun 14, 2014
Adp of the SNF Jun 14, 2014
Gregory Fernandez Individual Corporate DirectorBoard Member Nov 25, 2024

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rolling Fields IncConneautville, PA, CCN 395619 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 9, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764892800000",
    "number": "1366448706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 360",
            "city": "GERRY",
            "state": "NY",
            "postal_code": "147400360",
            "telephone_number": "716-985-6813",
            "fax_number": "716-985-6607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 PRATHER AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016710",
            "telephone_number": "716-488-1921",
            "fax_number": "716-484-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERRY HOMES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-21",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A",
        "authorized_official_last_name": "HAGLUND",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "716-488-1921"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "0602310N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENIOR CHOICE PROVIDER",
            "identifier": "00030010001",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01520369",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Park Rehab & Skilled Nursing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jamestown, NY

Sources for this page

Verify at the official NPI Registry.