NPIMap

Organization Active NPI

Willow Valley Communities

  • Skilled Nursing Facility
  • Willow Street, PA
National Provider Identifier
1740351584
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
233602 Issued in PA
Legal business name
WILLOW VALLEY COMMUNITIES
Practice address
300 Willow Valley Lakes Dr
Willow Street, PA 17584-9442
Phone
(717) 464-9542
Fax
(717) 464-1913
NPI assigned
Nov 13, 2006
Last updated
Mar 30, 2015By the provider in NPPES
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 of Directors
Phone
(717) 464-2741

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 233602 PA Primary

Addresses

Primary practice location

300 Willow Valley Lakes Dr
Willow Street, PA 17584-9442

Mailing address

300 Willow Valley Lakes Dr
Willow Street, PA 17584-9442
Phone (717) 464-6129

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100122000122 PA Part A Provider - Skilled Nursing Facility 9234048638 Practice locations: Willow Street, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740351584. Details of each certification follow.

Skilled nursing facility certification: CCN 395771

Legal name
WILLOW VALLEY COMMUNITIES
Doing business as
LAKESIDE AT WILLOW VALLEY
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Jan 1, 1989
Last certification
Dec 4, 2024
Beds
80
Ownership / control type
Nonprofit Corporation
Multi-facility organization
WILLOW VALLEY COMMUNITIES
Organization structure
CorporationProprietary
Incorporated
Dec 6, 1982 in PA
Enrollment address
300 Willow Valley Lakes Dr
Lakeside at Willow Way
Willow Street, PA 17584-9492
Nursing home name
LAKESIDE AT WILLOW VALLEY

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Lakeside at Willow ValleyCCN 395771 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare
Ownership
Non profit - Corporation
Certified
Jan 1, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8051.1 residents per day on average

Processed by Care Compare on Aug 1, 2026.

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 disclosed owners & managing parties 10

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

NameRoleSinceShare
Jill E Gilbert Individual Corporate OfficerPresident Board of Directors Apr 24, 2019
Susan B Allmond Individual Corporate Director May 1, 2022
Marvin Mashner Individual Corporate OfficerAssistant Treasurer - Bod May 1, 2022
John D Kemrer Individual Corporate Director Dec 1, 2009
Kristen M Loose Individual W-2 Managing EmployeeHealthcare Administrator Oct 17, 2016
Elric C Gerner Individual Corporate OfficerAssistant Secretary - Bod May 1, 2022
Gerald T Grant Individual Corporate OfficerVice Chair - Bod May 1, 2022
Willow Valley Communities Organization, Lancaster, PA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Oct 22, 2013 100%
Leslie W Brant Individual Corporate OfficerTreasurer Board of Directors Apr 24, 2019
Jane Barley Individual Corporate OfficerSecretary-Board of Directors Apr 19, 2012

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
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 1

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

Facilities with the same owner 1

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 7

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": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427673600000",
    "number": "1740351584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WILLOW VALLEY LAKES DR",
            "city": "WILLOW STREET",
            "state": "PA",
            "postal_code": "175849442",
            "telephone_number": "717-464-6129",
            "fax_number": "717-464-6034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WILLOW VALLEY LAKES DR",
            "city": "WILLOW STREET",
            "state": "PA",
            "postal_code": "175849442",
            "telephone_number": "717-464-9542",
            "fax_number": "717-464-1913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW VALLEY COMMUNITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "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 OF DIRECTORS",
        "authorized_official_telephone_number": "717-464-2741",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "233602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Street, PA

Sources for this page

Verify at the official NPI Registry.