Organization Active NPI

Moravian Village of Bethlehem, Inc.

  • Skilled Nursing Facility
  • Bethlehem, PA
National Provider Identifier
1710968458
Registry record updated Nov 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
15970201 Issued in PA
Legal business name
MORAVIAN VILLAGE OF BETHLEHEM, INC.
Practice address
526 Wood St
Bethlehem, PA 18018-4453
Phone
(610) 625-4885
Fax
(610) 625-2032
NPI assigned
Nov 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2008

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

Authorized official

Name
Mrs. Tracy A Patton
Title
Cfo
Phone
(610) 625-4885

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 15970201 PA Primary

Addresses

Primary practice location

526 Wood St
Bethlehem, PA 18018-4453

Mailing address

526 Wood St
Bethlehem, PA 18018-4453
Phone (610) 625-4885

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040420001460 PA Part A Provider - Skilled Nursing Facility 3476549197 Practice locations: Bethlehem, PA

Skilled nursing facility certification: CCN 396096

Legal name
MORAVIAN VILLAGE OF BETHLEHEM, INC.
Doing business as
MORAVIAN VILLAGE OF BETHLEHEM
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Jun 24, 2005
Last certification
Jun 18, 2025
Beds
93
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 30, 1999 in PA
Enrollment address
634 E Broad St
Bethlehem, PA 18018-6362
Nursing home name
MORAVIAN VILLAGE OF BETHLEHEM

Care Compare: Nursing home

Medicare Care Compare
Listed as
Moravian Village of BethlehemCCN 396096 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare
Ownership
Non profit - Corporation
Certified
Jun 24, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9351.7 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D1041896Moravian Village of Bethlehem526 Wood Street, Bethlehem, PA 18018Certificate of waiverJun 14, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 24

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

NameRoleSinceShare
Justin Michaels Individual Corporate DirectorExecutive Director Jan 1, 2026
Adp of the SNF Jul 1, 2024
Dwight Taylor Individual Corporate Director Feb 18, 2020
Art Sergent Individual Corporate DirectorBoard Member Feb 16, 2016
David Charrier Individual Corporate Director Feb 16, 2022
Richard Bach Individual Adp of the SNF Apr 1, 2022
Terri Boyd Individual Corporate Director Feb 18, 2020
Individual Trustee of the SNF Apr 21, 2004
Bethlehem Area Moravians, Inc Organization, Bethlehem, PA Non-profit 5% Or Greater Direct Ownership Interest Jun 24, 2005
Operational/Managerial Control Jun 24, 2005
Adp of the SNF Feb 12, 2025
Robin Gamble Individual Adp of the SNF Aug 16, 2024
Thomas Pheiffer Individual Corporate Director Feb 16, 2022
Phuong Ho Lien Pham Individual Adp of the SNF Feb 1, 2025
Douglas Kleintop Individual Corporate Director Feb 16, 2022
Tracy Patton Individual Corporate Director Apr 1, 2019
Adp of the SNF Apr 1, 2019
Individual Trustee of the SNF Sep 17, 2024
Beth Boyer Individual Corporate Director Feb 16, 2022
Brad Senick Individual Adp of the SNF Jan 1, 2018
Individual Trustee of the SNF Feb 20, 2024
Dan Miller Individual Corporate Director Feb 16, 2022
Brian Davison Individual Corporate DirectorBoard Member Feb 16, 2016
William Matz Individual Corporate Director Apr 21, 2004
Individual Trustee of the SNF Sep 17, 2024
Individual Trustee of the SNF Feb 19, 2022
Daniel Soos Individual Corporate Officer Jul 1, 2008
Corporate Director Jul 1, 2008
Operational/Managerial Control Jul 1, 2008
Adp of the SNF Jul 1, 2008
Carl Rohmann Individual Corporate Director Feb 16, 2022

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226620800000",
    "number": "1710968458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 WOOD ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180184453",
            "telephone_number": "610-625-4885",
            "fax_number": "610-625-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 WOOD ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180184453",
            "telephone_number": "610-625-4885",
            "fax_number": "610-625-2032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORAVIAN VILLAGE OF BETHLEHEM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2008-11-14",
        "status": "A",
        "authorized_official_last_name": "PATTON",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "610-625-4885",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "15970201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.