Lutheran Home - Hickory West, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NC0162 Issued in NC

Legal business name

LUTHERAN HOME - HICKORY WEST, INC

Practice address

1125 10TH Street Blvd NW
Hickory, NC 28601-3373

Phone

(828) 322-6995

Fax

(828) 322-7066

NPI assigned

Jul 14, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Gus Flaska

Title

Administrator

Phone

(828) 322-6995

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Skilled nursing facility certification: CCN 345106

Legal name

LUTHERAN HOME - HICKORY WEST, INC

Doing business as

TRINITY RIDGE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Dec 10, 1973

Last certification

Mar 27, 2025

Beds

120

Ownership / control type

Nonprofit Corporation

Multi-facility organization

Lutheran Services Carolinas

Organization structure

CorporationNon-profit

Incorporated

Jul 29, 2004 in NC

Enrollment address

2140 Medical Park Drive
Hickory, NC 28602

Nursing home name

TRINITY RIDGE

Affiliated entity

LUTHERAN SERVICES CAROLINAS

Listed as

Trinity RidgeCCN 345106

Overall star rating

5 of 5

Health inspections

4 of 5

Staffing

5 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Dec 10, 1973

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

120111.3 residents per day on average

Chain

Lutheran Services Carolinas9 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Lutheran Home - Hickory West3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Lutheran Home - Hickory West

  • Skilled Nursing Facility
  • Hickory, NC
  • NPI 1124202759
  NPD tax ID
• Lutheran Home - Hickory West

  • Nursing Facility/Intermediate Care Facility
  • Hickory, NC
  • NPI 1629251426
  NPD tax ID

All disclosed owners & managing parties 11

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.

• John Steven Corder, M.D.

  • Family Medicine Physician
  • Asheville, NC
  • NPI 1154300820

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 6

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

• Lutheran Home - Forsyth County, Inc.

  • Skilled Nursing Facility
  • Clemmons, NC
  • NPI 1912323635

  Lsa Management, Inc.

  CMS ownership
• Lutheran Home - Wilmington, Inc.

  • Skilled Nursing Facility
  • Wilmington, NC
  • NPI 1194028118

  Lsa Management, Inc.

  CMS ownership
• Lutheran Home at Trinity Oaks, Inc.

  • Skilled Nursing Facility
  • Salisbury, NC
  • NPI 1447254149

  Lsa Management, Inc.

  CMS ownership
• Lutheran Home- Albemarle, Inc.

  • Skilled Nursing Facility
  • Albemarle, NC
  • NPI 1215931977

  Lsa Management, Inc.

  CMS ownership
• Lutheran Home-Hickory, Inc.

  • Skilled Nursing Facility
  • Hickory, NC
  • NPI 1427052067

  Lsa Management, Inc., Lutheran Home Hickory West Property, Inc.

  CMS ownership
• Lutheran Home-Winston-Salem, Inc.

  • Skilled Nursing Facility
  • Winston Salem, NC
  • NPI 1912902230

  Lsa Management, Inc.

  CMS ownership

Practitioners 1

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

• John Steven Corder, M.D.

  • Family Medicine Physician
  • Asheville, NC
  • NPI 1154300820
  NPD (past)

Affiliated clinicians 1

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

• John Steven Corder, M.D.

  • Family Medicine Physician
  • Asheville, NC
  • NPI 1154300820

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770163200000",
    "number": "1508864323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 10TH STREET BLVD NW",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013373",
            "telephone_number": "828-322-6995",
            "fax_number": "828-322-7066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 10TH STREET BLVD NW",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013373",
            "telephone_number": "828-322-6995",
            "fax_number": "828-322-7066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN HOME - HICKORY WEST, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-14",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A",
        "authorized_official_last_name": "FLASKA",
        "authorized_official_first_name": "GUS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "828-322-6995",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NC0162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3425106",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Lee Lum, CRNA
• Tina Lashae Lum, NP
• Lutheran Family Services in the Carolinas
• Lutheran Home - Hickory West
• Lutheran Home - Hickory West
• Lutheran Home- Hickory, Inc.
• Lutheran Home-Hickory
• Lutheran Home-Hickory, Inc.
• Lutheran Home-Hickory, Inc.
• Laura Lutz, MA, CCC-SLP

• Skilled Nursing Facility in Hickory, NC
• Providers in Hickory, NC by specialty
• Skilled Nursing Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.