NPIMap

Organization Active NPI

Orchard Park CCRC, Inc.

Doing business as Fox Run at Orchard Park

  • Skilled Nursing Facility
  • Orchard Park, NY
National Provider Identifier
1639363153
Registry record updated Mar 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ORCHARD PARK CCRC, INC.
Doing business as
Fox Run at Orchard Park
Practice address
One Fox Run Lane
Orchard Park, NY 14127
Phone
(716) 662-5001
Fax
(716) 662-6985
NPI assigned
Aug 28, 2007
Last updated
Mar 8, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2011

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

Authorized official

Name
Mr. William L. Wlodarczyk, CHIEF FINANCIAL OFFI
Title
Chief Financial Officer
Phone
(716) 662-5001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

One Fox Run Lane
Orchard Park, NY 14127

Mailing address

One Fox Run Lane
Orchard Park, NY 14127
Phone (716) 662-5001

Other identifiers 1

IdentifierTypeStateIssuer
02967540MedicaidNY

Other names 1

  • Fox Run at Orchard Park Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071002000044 NY Part A Provider - Skilled Nursing Facility 4789779059 Practice locations: Orchard Park, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639363153. Details of each certification follow.

Skilled nursing facility certification: CCN 335854

Legal name
ORCHARD PARK CCRC, INC.
Doing business as
FOX RUN AT ORCHARD PARK
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 15, 2008
Last certification
Mar 7, 2025
Beds
60
Ownership / control type
Corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 20, 2000 in NY
Enrollment address
1 Fox Run LN
Orchard Park, NY 14127-3165
Nursing home name
FOX RUN AT ORCHARD PARK

Care Compare: Nursing home

Medicare Care Compare
Listed as
Fox Run at Orchard ParkCCN 335854 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Feb 15, 2008
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6051.3 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Marja Coons-Torn Individual Managing Control - Governing BodyBoard Member May 31, 2019
Francis Vavonese Individual Managing Control - Governing BodyBoard Member Jun 1, 2024
Theresa Hart Individual Managing Control - Governing BodyBoard Member May 31, 2021
Manufacturers & Traders Trust Company Organization, Buffalo, NY Financial institution Operational/Managerial Control Jan 13, 2025
Adp of the SNF Jan 13, 2025
Benjamin Rand Individual Managing Control - Governing BodyBoard Member Jun 1, 2017
Jill L Szalach Individual Corporate OfficerChief Financial Officer Aug 1, 2013
Adp of the SNF Jan 8, 2025
John Sherman Individual Managing Control - Governing BodyBoard Member May 31, 2013
Allysa Olsen Individual Operational/Managerial Control Oct 20, 2020
Adp of the SNF Oct 20, 2020
Ronald C Witt Individual Managing Control - Governing BodyBoard Member May 31, 2015
Michael H Kueker Individual Operational/Managerial Control Aug 1, 2022
Adp of the SNF Aug 1, 2002
Craig Clark Individual Managing Control - Governing BodyBoard Member May 31, 2021
Patricia Thoman Individual Operational/Managerial Control Feb 5, 2008
Adp of the SNF Feb 5, 2008
George Herbert Individual Managing Control - Governing BodyBoard Member May 31, 2012
Robert Hoover Individual Managing Control - Governing BodyBoard Member Jun 1, 2023
Morrison Management Specialists Inc Organization, Atlanta, GA Corporation Operational/Managerial Control Jan 10, 2025
Adp of the SNF Jan 10, 2025
Terrie Murray Individual Managing Control - Governing BodyBoard Member Jun 1, 2024
Gretchen Librock Individual Managing Control - Governing BodyBoard Member May 31, 2013
William L Wlodarczyk Individual Corporate OfficerChief Executive Officer Jul 1, 2013
Adp of the SNF Jan 8, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 10

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

Practitioners & affiliated clinicians

Practitioners 1

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 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": "1188259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299542400000",
    "number": "1639363153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE FOX RUN LANE",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "14127",
            "telephone_number": "716-662-5001",
            "fax_number": "716-662-6985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE FOX RUN LANE",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "14127",
            "telephone_number": "716-662-5001",
            "fax_number": "716-662-6985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORCHARD PARK CCRC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-28",
        "last_updated": "2011-03-08",
        "status": "A",
        "authorized_official_last_name": "WLODARCZYK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "716-662-5001",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CHIEF FINANCIAL OFFI"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02967540",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fox Run at Orchard Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.