NPIMap

Organization Active NPI

Willow Valley Communities

  • Rehabilitation Practitioner
  • Willow Street, PA
National Provider Identifier
1609940014
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Legal business name
WILLOW VALLEY COMMUNITIES
Practice address
900 Willow Valley Lakes Dr
Willow Street, PA 17584-9663
Phone
(717) 464-6861
Fax
(717) 464-6898
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Authorized official

Name
Mr. James Hostetter
Title
President of Board Directors
Phone
(717) 464-2741

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 225400000X Primary

Addresses

Primary practice location

900 Willow Valley Lakes Dr
Willow Street, PA 17584-9663

Mailing address

900 Willow Valley Lakes Dr
Willow Street, PA 17584-9663
Phone (717) 464-2741

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030303000018 PA Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 9234048638 Practice locations: Willow Street, PA

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
The Glen PC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Ownership & related parties

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Lakeside at Willow ValleyWillow Street, PA, CCN 395771 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 22, 2013
The Glen at Willow ValleyLancaster, PA, CCN 395956 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 6, 1982

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 10

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": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427673600000",
    "number": "1609940014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 WILLOW VALLEY LAKES DR",
            "city": "WILLOW STREET",
            "state": "PA",
            "postal_code": "175849663",
            "telephone_number": "717-464-2741",
            "fax_number": "717-464-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WILLOW VALLEY LAKES DR",
            "city": "WILLOW STREET",
            "state": "PA",
            "postal_code": "175849663",
            "telephone_number": "717-464-6861",
            "fax_number": "717-464-6898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW VALLEY COMMUNITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2015-03-30",
        "status": "A",
        "authorized_official_last_name": "HOSTETTER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT OF BOARD DIRECTORS",
        "authorized_official_telephone_number": "717-464-2741",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Street, PA

Sources for this page

Verify at the official NPI Registry.