NPIMap

Organization Active NPI

Goodwin House Incorporated

Doing business as Goodwin House Bailey's Crossroads

  • Skilled Nursing Facility
  • Falls Church, VA
National Provider Identifier
1639258676
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH2559 Issued in VA
Legal business name
GOODWIN HOUSE INCORPORATED
Doing business as
Goodwin House Bailey's Crossroads
Practice address
3440 S Jefferson St
Falls Church, VA 22041-3145
Phone
(703) 820-1488
Fax
(703) 824-1241
NPI assigned
Nov 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Andrew M Siegel
Title
Chief Business Development Officer
Phone
(703) 578-7554

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH2559 VA Primary

Addresses

Primary practice location

3440 S Jefferson St
Falls Church, VA 22041-3145

Mailing address

4800 Fillmore Ave
Alexandria, VA 22311-5070
Phone (703) 824-1290

Other identifiers 1

IdentifierTypeStateIssuer
4951719MedicaidVA

Other names 1

  • Goodwin House Bailey's Crossroads Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120521000084 VA Part A Provider - Skilled Nursing Facility 8325171523 Practice locations: Falls Church, VA
O20140319000072 DC Part B Supplier - Clinic/Group Practice 8325171523 Receives reassigned benefits from 3 practitioners
Practice locations: Alexandria, VA; Falls Church, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639258676. Details of each certification follow.

Skilled nursing facility certification: CCN 495171

Legal name
GOODWIN HOUSE INCORPORATED
Doing business as
GOODWIN HOUSE BAILEY'S CROSSROADS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 4, 1987
Last certification
Aug 21, 2024
Beds
73
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Goodwin House Incorporated
Organization structure
CorporationNon-profit
Incorporated
Aug 4, 1955 in VA
Enrollment address
3440 South Jefferson St
Falls Church, VA 22041-3145
Nursing home name
GOODWIN HOUSE BAILEY'S CROSSROADS

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Goodwin House Bailey's CrossroadsCCN 495171 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Nov 4, 1987
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7367.4 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Brayshaw Bernanke4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 28

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

NameRoleSinceShare
Garrett Weis Erdle Individual OtherBoard Member Jan 1, 2024
Mary Hix Individual Corporate OfficerVice Chair and Treasurer Jan 1, 2014
Corporate DirectorBoard Member Jan 1, 2012
Lisa Giesler Individual OtherBoard Member Jan 1, 2024
Cyrillene Clark Individual Corporate DirectorBoard Member Jan 1, 2013
OtherBoard Member Jan 1, 2013
Vipin Sahijwani Individual OtherBoard Member-Treasurer Jan 1, 2024
Holly Hanisian Individual Corporate OfficerAssistant Secretary Sep 8, 2016
Tom Regnell Individual Corporate DirectorBoard Member Jan 1, 2014
David Clarke Individual Corporate DirectorBoard Member Jan 1, 2013
Melinda Hudson Individual Corporate OfficerSecretary Jan 1, 2013
Corporate Director Jan 1, 2012
Justin Carwile Individual Corporate DirectorExecutive Director Nov 1, 2016
Andrew Siegel Individual Corporate OfficerChief Business Development Offic May 23, 2017
W-2 Managing Employee May 23, 2017
Tucker Alexander Eskew Individual OtherBoard Member-Secretary Jan 1, 2024
Robert a Liebreich Individual 5% Or Greater Indirect Ownership InterestPresident & Ceo Jul 1, 2019 5%
Ben B Marchantonio Individual OtherBoard Member Jan 1, 2024
Phoebe Choi Individual Corporate Officer Dec 21, 2020
W-2 Managing EmployeeFinance Manager Dec 21, 2020
Anthony Joseph Tambasco Individual OtherBoard Member Jan 1, 2024
Nancy Randolph Individual Corporate DirectorBoard Member Jan 1, 2013
Charles Smith Individual Corporate DirectorBoard Member Jan 1, 2012
John M Weaver Individual OtherBoard Member-Secretary Jan 1, 2024
Deborah Forbes Individual Corporate DirectorBoard Member Jan 1, 2012
Sherretta Bernateau Individual Corporate Officer Sep 19, 2019
W-2 Managing EmployeeAcct Receivable Manager Sep 19, 2019
Chandra M Kumar Individual Corporate OfficerChief Operating Officer Feb 14, 2023
OtherBoard Member Jan 1, 2024
Timothy Smith Individual Corporate OfficerCfo Aug 30, 2021
W-2 Managing Employee Aug 30, 2021
Thomas C West Individual Corporate DirectorBoard Member Jan 1, 2014
Mark Mellott Individual OtherBoard Member Jan 1, 2010
Janet Hansen Individual Corporate DirectorBoard Member Jan 1, 2012
Nina Janopaul Individual OtherBoad Member Jan 1, 2024
Donald Calloway Individual Corporate OfficerChairman Jan 1, 2014
Corporate DirectorBoard Member Jan 1, 2012

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Goodwin Home HealthFalls Church, VA, CCN 497662 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jan 2, 2020

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 4

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.

Affiliated clinicians 9

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": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1639258676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 FILLMORE AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223115070",
            "telephone_number": "703-824-1290",
            "fax_number": "703-824-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 S JEFFERSON ST",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220413145",
            "telephone_number": "703-820-1488",
            "fax_number": "703-824-1241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODWIN HOUSE INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2025-09-02",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "SIEGEL",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF BUSINESS DEVELOPMENT OFFICER",
        "authorized_official_telephone_number": "703-578-7554"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "VA",
            "license": "NH2559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4951719",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goodwin House Bailey's Crossroads",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Falls Church, VA

Sources for this page

Verify at the official NPI Registry.