NPIMap

Organization Active NPI

Christian Health Care Center

  • Skilled Nursing Facility
  • Wyckoff, NJ
National Provider Identifier
1427047232
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
060204 Issued in NJ
Legal business name
CHRISTIAN HEALTH CARE CENTER
Practice address
301 Sicomac Ave
Wyckoff, NJ 07481-2159
Phone
(201) 848-5500
Fax
(201) 848-5493
NPI assigned
Oct 14, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Kevin A Stagg
Title
Executive Vice President
Phone
(201) 848-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 060204 NJ Primary

Addresses

Primary practice location

301 Sicomac Ave
Wyckoff, NJ 07481-2159

Mailing address

301 Sicomac Ave
Wyckoff, NJ 07481-2159
Phone (201) 848-5500

Other identifiers 1

IdentifierTypeStateIssuer
4463501MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040426000168 NJ Part B Supplier - Clinic/Group Practice 7618887340 Receives reassigned benefits from 7 practitioners
Practice locations: Wyckoff, NJ
O20100115000727 NJ Part A Provider - Skilled Nursing Facility 7618887340 Practice locations: Wyckoff, NJ

Skilled nursing facility certification: CCN 315376

Legal name
CHRISTIAN HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Oct 1, 1997
Last certification
Oct 8, 2024
Beds
304
Ownership / control type
Church Related
Organization structure
CorporationProprietary
Incorporated
Feb 15, 1935 in NJ
Enrollment address
301 Sicomac Ave
Wyckoff, NJ 07481-2159
Nursing home name
CHRISTIAN HEALTH CARE CENTER

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Christian Health Care CenterCCN 315376
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Church related
Certified
Oct 1, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
304282.4 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Dr Richard Ilver7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Stephen Dumke Individual Corporate OfficerCeo Jan 1, 2025
Operational/Managerial Control Jan 1, 2025
Indirect Ownership Interest Jan 1, 2025
Kevin Stagg Individual Corporate OfficerExecutive Vice President and Cfo Dec 1, 1997
Erik D Svensson Individual Corporate Director Nov 1, 2024
Adp of the SNF Dec 29, 2025
Christian Health Care Center Organization, Wyckoff, NJ 5% Or Greater Direct Ownership Interest Dec 1, 1997
Operational/Managerial Control Dec 1, 1997
Myrna Gomez Individual Corporate DirectorNursing Home Adminisrator Jul 5, 2022
Adp of the SNF Dec 29, 2025

Owners & managing parties with NPI records 2

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
WindmereNorth Haledon, NJ, CCN 315531 Skilled nursing facility Operational/Managerial Control Oct 3, 2022

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

Affiliated clinicians 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427047232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SICOMAC AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074812159",
            "telephone_number": "201-848-5500",
            "fax_number": "201-848-5493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SICOMAC AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074812159",
            "telephone_number": "201-848-5500",
            "fax_number": "201-848-5493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN HEALTH CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STAGG",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "201-848-5200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NJ",
            "license": "060204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4463501",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyckoff, NJ

Sources for this page

Verify at the official NPI Registry.