NPIMap

Organization Active NPI

Annapolis Life Care, Inc.

Doing business as Ginger Cove

  • Skilled Nursing Facility
  • Annapolis, MD
National Provider Identifier
1407847247
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
02-001 Issued in MD
Legal business name
ANNAPOLIS LIFE CARE, INC.
Doing business as
Ginger Cove
Practice address
4000 River Crescent Dr
Annapolis, MD 21401-7721
Phone
(410) 266-7300
Fax
(410) 266-6144
NPI assigned
Nov 1, 2005
Last updated
Jun 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Authorized official

Name
Mrs. Phyllis Boulden
Title
Administrator
Phone
(410) 266-7300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 02-001 MD Primary

Addresses

Primary practice location

4000 River Crescent Dr
Annapolis, MD 21401-7721

Mailing address

4000 River Crescent Dr
Annapolis, MD 21401-7721
Phone (410) 266-7300

Other names 1

  • Ginger Cove Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111108000137 MD Part A Provider - Skilled Nursing Facility 7315110368 Practice locations: Annapolis, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407847247. Details of each certification follow.

Skilled nursing facility certification: CCN 215174

Legal name
ANNAPOLIS LIFE CARE, INC.
Doing business as
GINGER COVE
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Sep 16, 1988
Last certification
Jun 4, 2024
Beds
55
Ownership / control type
Other Nonprofit
Organization structure
CorporationNon-profit
Incorporated
Jun 2, 1982 in MD
Enrollment address
4000 River Crescent Dr
Annapolis, MD 21401-7721
Nursing home name
GINGER COVE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Ginger CoveCCN 215174 · All quality measures
Overall star rating
4 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
1 of 5
Type
Medicare
Ownership
Non profit - Other
Certified
Sep 16, 1988
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5540.5 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
21D1003830Ginger Cove Home Health Care LLC4000 River Crescent Drive, Annapolis, MD 21401Certificate of waiverSep 11, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Donald Raymond Fisher Individual Corporate OfficerChief Executive Officer Dec 6, 2021
W-2 Managing EmployeeChief Executive Officer Dec 6, 2021
Phyllis J Boulden Individual Corporate DirectorAdministrator Apr 29, 2016
W-2 Managing EmployeeAdministrator Nov 16, 1992

Practitioners & affiliated clinicians

Affiliated clinicians 10

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": "1130803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1407847247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 RIVER CRESCENT DR",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017721",
            "telephone_number": "410-266-7300",
            "fax_number": "410-266-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 RIVER CRESCENT DR",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017721",
            "telephone_number": "410-266-7300",
            "fax_number": "410-266-6144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNAPOLIS LIFE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-01",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "BOULDEN",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "410-266-7300",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": "02-001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ginger Cove",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.