NPIMap

Organization Active NPI

Bonita Springs Retirement Village, Inc.

Doing business as The Terraces at Bonita Springs

  • Skilled Nursing Facility
  • Bonita Springs, FL
National Provider Identifier
1700126802
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
SNF130471054 Issued in FL
Legal business name
BONITA SPRINGS RETIREMENT VILLAGE, INC.
Doing business as
The Terraces at Bonita Springs
Practice address
26455 S Tamiami TRL
Bonita Springs, FL 34134-7815
Phone
(239) 949-7555
Fax
(239) 949-7559
NPI assigned
Feb 26, 2013
Last updated
Nov 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Authorized official

Name
Mr. Karl Goedert
Title
Controller
Phone
(352) 337-8798

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU
Skilled Nursing Facility 314000000X SNF130471054 FL Primary

Addresses

Primary practice location

26455 S Tamiami TRL
Bonita Springs, FL 34134-7815

Mailing address

26455 S Tamiami TRL
Bonita Springs, FL 34134-7815
Phone (239) 949-7555

Other names 1

  • The Terraces at Bonita Springs Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130826001063 FL Part A Provider - Skilled Nursing Facility 5496998270 Practice locations: Bonita Springs, FL
O20140819001276 FL Part B Supplier - Clinic/Group Practice 2860619632 Receives reassigned benefits from 588 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700126802. Details of each certification follow.

Skilled nursing facility certification: CCN 106104

Legal name
BONITA SPRINGS RETIREMENT VILLAGE INC
Doing business as
WILLOWBROOKE COURT SKILLED CARE CENTER AT THE TERRACES
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 5, 2013
Last certification
Jul 3, 2024
Beds
40
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Santa Fe Senior Living
Organization structure
CorporationNon-profit
Incorporated
Feb 29, 2008 in FL
Enrollment address
26455 S Tamiami TRL
Bonita Springs, FL 34134-7815
Nursing home name
RENAISSANCE AT THE TERRACES
Affiliated entity
ACTS RETIREMENT-LIFE COMMUNITIES

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Renaissance at the TerracesCCN 106104 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Dec 5, 2013
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4031.9 residents per day on average
Chain
Acts Retirement-Life Communities27 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Member of 4

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 24

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

View all 24

Locations

418 SW 47th Ter
Cape Coral, FL 33914
Phone (239) 673-9034

1737 N Clyde Morris Blvd
Ste 300
Daytona Beach, FL 32117
Phone (386) 262-1627

12590 Whitehall Dr
Fort Myers, FL 33907
Phone (239) 939-9090

6714 Winkler Rd
Fort Myers, FL 33919
Phone (239) 215-1025

1201 US Highway 1
North Palm Beach, FL 33408
Phone (561) 747-2775

3157 N Alafaya Trl
Orlando, FL 32826
Phone (407) 215-0095

3191 Harbor Blvd
Ste A
Pt Charlotte, FL 33952
Phone (941) 766-9555

926 Cypress Village Blvd
Ste B
Sun City Center, FL 33573
Phone (813) 819-5271

7916 Evolutions Way
Ste 102
Trinity, FL 34655
Phone (727) 910-5990

Ownership & related parties

All disclosed owners & managing parties 26

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

NameRoleSinceShare
Susan Ahern Individual Corporate OfficerTreasurer Nov 1, 2024
Operational/Managerial Control Nov 1, 2024
Adp of the SNF Nov 1, 2024
Peggy Valdivia Individual Corporate OfficerAssistant Treasurer Nov 1, 2024
Operational/Managerial Control Nov 1, 2024
Adp of the SNF Nov 1, 2024
Acts Communities of Maryland, Inc. Organization, Fort Washington, PA Corporation, Non-profit, Owned by another organization or individual Indirect Ownership Interest Nov 1, 2024
Acts Retirement-Life Communities Inc Organization, Fort Washington, PA Corporation, Non-profit, Chain home office, Owned by another organization or individual Indirect Ownership Interest Nov 1, 2024 100%
Karen I Christiansen Individual Corporate OfficerPresident & Vice Chairman Nov 1, 2024
Corporate DirectorBoard Member Nov 1, 2024
Operational/Managerial Control Nov 1, 2024
Adp of the SNF Nov 1, 2024
Acts Management Services, Inc. Organization, Fort Washington, PA Corporation, Management services company, Non-profit Operational/Managerial Control Nov 1, 2024
Adp of the SNF Jul 25, 2025
Indirect Ownership Interest Nov 1, 2024
Acts Legacy Foundation, Inc. Organization, Fort Washington, PA Corporation, Non-profit, Owned by another organization or individual Indirect Ownership Interest Nov 1, 2024
Acts Retirement-Life Communities Management, LLC Organization, Fort Washington, PA LLC, Management services company Operational/Managerial Control Nov 1, 2024
Adp of the SNF Jul 25, 2025
Indirect Ownership Interest Nov 1, 2024
Baker Tilly US LLP Organization, Madison, WI Adp of the SNF Nov 5, 2024
Acts Acquisition and Development Company LLC Organization, Fort Washington, PA Created for acquisition, LLC, Owned by another organization or individual Indirect Ownership Interest Nov 1, 2024
Jonathan D Grant Individual Corporate OfficerAssistant Secretary Nov 1, 2024
Operational/Managerial Control Nov 1, 2024
Adp of the SNF Nov 1, 2024
Acts Signature Community Services Inc Organization, Fort Washington, PA Corporation, Non-profit, Owned by another organization or individual Indirect Ownership Interest Nov 1, 2024
Bonita Springs Retirement Village Inc Organization, Fort Washington, PA Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Nov 7, 2013 100%
5% Or Greater Mortgage Interest Nov 7, 2013 100%
Operational/Managerial Control Nov 7, 2013
Adp of the SNF Nov 7, 2013
Elric C Gerner Individual Corporate OfficerSecretary Nov 1, 2024
Corporate DirectorBoard Member Nov 1, 2024
Gerald T Grant Individual Corporate OfficerCeo & Chairman Nov 1, 2024
Corporate DirectorBoard Member Nov 1, 2024
Operational/Managerial Control Nov 1, 2024
Adp of the SNF Nov 1, 2024
Umb Bank National Association Organization, Kansas City, MO Corporation, Financial institution Trustee of the SNF Jan 1, 2022
Adp of the SNF Jul 24, 2025
Acts Retirement Services, Inc Organization, Fort Washington, PA Corporation, Non-profit Indirect Ownership Interest Nov 1, 2024
David Gray Individual Adp of the SNF Nov 1, 2024
Glenn D Fox Individual Corporate OfficerAssistant Secretary Nov 1, 2024
Operational/Managerial Control Nov 1, 2024
Adp of the SNF Nov 1, 2024
Baker Tilly Advisory Group LP Organization, Madison, WI Adp of the SNF Feb 3, 2025
Sajid Sipra Individual Adp of the SNF Nov 1, 2015
James Glynn Individual Corporate DirectorBoard Member Nov 1, 2024
Acts Alliance Management LLC Organization, Fort Washington, PA LLC, Management services company, Owned by another organization or individual Indirect Ownership Interest Nov 1, 2024
Dave Moreland Individual Corporate DirectorBoard Member Nov 1, 2024
Mease Life Inc Organization, Fort Washington, PA Corporation, Non-profit, Owned by another organization or individual Indirect Ownership Interest Nov 1, 2024
Rita Weiss Individual Corporate DirectorBoard Member Nov 1, 2024

Owners & managing parties with NPI records 19

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

View all 19

All facility ownership & control disclosures 24

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

FacilityTypeRoleSince
Willowbrooke Court Skilled Care Center at Fort Washington EstatesFort Washington, PA, CCN 395496 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
Willowbrooke Court at Indian River EstatesVero Beach, FL, CCN 105593 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
Willowbrooke Court SC Ctr at Matthews GlenMatthews, NC, CCN 345326 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
Willowbrooke Court Skilled Care Center-Edgewater at Boca PointeBoca Raton, FL, CCN 105489 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
Willowbrooke Court at St. Andrews EstatesBoca Raton, FL, CCN 105355 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
Willowbrooke Court at Southampton EstatesSouthampton, PA, CCN 395490 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
Willowbrooke Court at Granite Farms EstatesMedia, PA, CCN 395736 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
Willowbrooke Court SC Center at Tryon EstatesColumbus, NC, CCN 345459 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
Willowbrooke Court Skilled Care Center at Normandy Farms EstatesBlue Bell, PA, CCN 395665 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
Willowbrooke Court Skilled Care Center at Lima EstatesLima, PA, CCN 395492 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
Willowbrooke Court at Spring House EstatesLower Gwynedd, PA, CCN 395495 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
Willowbrooke Court Skilled Care Center at Brittany Pointe EstatesLansdale, PA, CCN 395762A Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
Willowbrooke Court at Lanier Village EstatesGainesville, GA, CCN 115687 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
Willowbrooke Court at Azalea TracePensacola, FL, CCN 105444 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
The Cedar at Mease LifeDunedin, FL, CCN 105732 Skilled nursing facility Indirect Ownership Interest Oct 1, 2023
Willowbrooke Court Skilled Care Center at Magnolia TraceHuntsville, AL, CCN 015450 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
Willowbrooke Court at Cokesbury VillageHockessin, DE, CCN 085017 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
Willowbrooke Court at Country HouseWilmington, DE, CCN 085003 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
Willowbrooke Court at Manor HouseSeaford, DE, CCN 085009 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
Willowbrooke Court Skilled Care Center at FairhavenSykesville, MD, CCN 215130 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
Willowbrooke Court Skilled Care Center at Buckingham's ChoiceAdamstown, MD, CCN 215329 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
Willowbrooke Court Skilled Care Center at Bayleigh ChaseEaston, MD, CCN 215137 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
Willowbrooke Court Skilled Care at EvergreensMoorestown, NJ, CCN 315077 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
Willowbrooke Court Skilled Care Center at Heron PointChestertown, MD, CCN 215235 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024

Owned or controlled facilities with NPI records 24

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

View all 24

Facilities with the same owner 30

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

View all 30

Practitioners & affiliated clinicians

Practitioners 526

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.

View all 526

Affiliated clinicians 2

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": "1361836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1700126802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26455 S TAMIAMI TRL",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341347815",
            "telephone_number": "239-949-7555",
            "fax_number": "239-949-7559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26455 S TAMIAMI TRL",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341347815",
            "telephone_number": "239-949-7555",
            "fax_number": "239-949-7559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONITA SPRINGS RETIREMENT VILLAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-26",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "GOEDERT",
        "authorized_official_first_name": "KARL",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "352-337-8798",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF130471054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Terraces at Bonita Springs",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Terraces at Bonita Springs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bonita Springs, FL

Sources for this page

Verify at the official NPI Registry.