Active NPI
Culpeper Baptist Retirement Community
- Nursing Facility/Intermediate Care Facility
- Culpeper, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- License
- NH2541
- Legal business name
- CULPEPER BAPTIST RETIREMENT COMMUNITY
- Practice address
- 12425 Village Loop
Box 191
Culpeper, VA 22701-0191 - Phone
- (540) 825-2411
- NPI assigned
- Mar 15, 2006
- Last updated
- Jan 27, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. James Francis Jacobsen, LNHA
- Title
- Executive Director
- Phone
- (540) 825-2411
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | WLO055725 | VA | |
| Nursing Facility/Intermediate Care Facility | 313M00000X | NH2541 | VA | Primary |
| Skilled Nursing Facility | 314000000X | NU |
Addresses
Primary practice location
12425 Village Loop
Box 191
Culpeper, VA 22701-0191
Mailing address
PO Box 191
12425 Village Loop
Culpeper, VA 22701-0191
Phone (540) 825-2411
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004967658 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090811000139 | VA | Part A Provider - Skilled Nursing Facility | 3072511161 | Practice locations: Culpeper, VA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1437128154. Details of each certification follow.
Skilled nursing facility certification: CCN 495400
- Legal name
- CULPEPER BAPTIST RETIREMENT COMMUNITY
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Feb 1, 2010
- Last certification
- Oct 18, 2023
- Beds
- 47
- Ownership / control type
- Nonprofit Corporation
- Multi-facility organization
- Lifespire of Virginia
- Organization structure
- Corporation
- Incorporated
- Jan 24, 1984 in VA
- Enrollment address
- 12425 Village Loop
Culpeper, VA 22701-4375 - Nursing home name
- THE CULPEPER
Care Compare: Nursing home
Medicare Care Compare- Listed as
- The Culpeper
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Feb 1, 2010
- Medicare certification status
- Active
- Certified beds
- 47
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 49D0886907 | Culpeper Baptist Retirement Community | Certificate of waiver | May 30, 2028 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 25
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Sallie Marchello | Corporate Director | Jan 1, 2018 | |
| Samuel Oakey | Corporate Director | Aug 1, 2009 | |
| John Jung | Corporate Director | Jan 1, 2021 | |
| Michael Keck | Corporate Director | Aug 1, 2009 | |
| Jim Poats | Corporate Director | Jan 1, 2022 | |
| John Peter Robinson | Corporate Officer | Feb 1, 2018 | |
| James Bales | Corporate Director | Jan 1, 2019 | |
| Christine Moran | Corporate Officer | Mar 31, 2021 | |
| Arne Owens | Corporate Director | Jan 1, 2020 | |
| Gary Thomson | Corporate Director | Jan 1, 2022 | |
| Charles Harris | Corporate Director | Aug 1, 2009 | |
| Lisa Hawthorne | Corporate Officer | Jun 14, 2021 | |
| Jonathan Robert Cook | Corporate Officer | Jan 1, 2015 | |
| Virginia Baptist Homes Inc | Operational/Managerial Control | Aug 1, 2009 | 100% |
| James F Jacobsen | W-2 Managing Employee | Feb 1, 2018 | |
| Valerie Carter | Corporate Director | Feb 1, 2018 | |
| John Poma | Corporate Director | Jan 1, 2021 | |
| Daniel Carlton | Corporate Officer | Dec 31, 2021 | |
| Tracey Albritton | Corporate Officer | Dec 1, 2021 | |
| Sharon Brooks | Corporate Director | Jan 1, 2021 | |
| Herbert Browning | Corporate Director | Aug 1, 2009 | |
| Matthew Scott | Corporate Director | Feb 1, 2018 | |
| R Scott Cave | Corporate Director | Dec 31, 2021 | |
| Christopher M Markwith | Corporate Officer | Jan 31, 2018 | |
| Tiffany Franks | Corporate Director | Jan 1, 2020 |
Facilities with the same owner 3
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Nursing Facility/Intermediate Care Facility
- Richmond, VA
- NPI 1447491394
Virginia Baptist Homes Inc
-
dba The Chesapeake
- Nursing Facility/Intermediate Care Facility
- Newport News, VA
- NPI 1124122619
Virginia Baptist Homes Inc
-
- Nursing Facility/Intermediate Care Facility
- Daleville, VA
- NPI 1376784488
Virginia Baptist Homes Inc
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Nurse Practitioner
- Culpeper, VA
- NPI 1912954199
-
- Internal Medicine Physician
- Culpeper, VA
- NPI 1871528547
-
- Clinical Social Worker
- Culpeper, VA
- NPI 1689738734
-
- Internal Medicine Physician
- Culpeper, VA
- NPI 1902831670
-
- Family Nurse Practitioner
- Staunton, VA
- NPI 1568497246
Affiliated clinicians 1
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": "1142380800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1674777600000",
"number": "1437128154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 191",
"address_2": "12425 VILLAGE LOOP",
"city": "CULPEPER",
"state": "VA",
"postal_code": "227010191",
"telephone_number": "540-825-2411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12425 VILLAGE LOOP",
"address_2": "BOX 191",
"city": "CULPEPER",
"state": "VA",
"postal_code": "227010191",
"telephone_number": "540-825-2411"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CULPEPER BAPTIST RETIREMENT COMMUNITY",
"organizational_subpart": "NO",
"enumeration_date": "2006-03-15",
"last_updated": "2023-01-27",
"certification_date": "2023-01-27",
"status": "A",
"authorized_official_last_name": "JACOBSEN",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "FRANCIS",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "540-825-2411",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "LNHA"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "VA",
"license": "WLO055725",
"primary": false
},
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "VA",
"license": "NH2541",
"primary": true
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004967658",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Culpeper, VA
- Craig G Hoover O D and Associates PLLC
- Cathy Annette Crain, RPH
- Anthony J Crimaldi II, MD
- Jordan J. Crovatin Jr., MD
- Culpeper Anesthesia Group, LLC
- Culpeper Cab Company LLC
- Culpeper Care Center LLC (Culpeper Health & Rehabilitation Center)
- Culpeper County Board of Supervisors (Culpeper County Office of Emergency Services)
- Culpeper County Dental Clinic
- Culpeper County Health Dept.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; 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.