Wesley Manor Retirement Community Inc.

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

100230 Issued in KY

Legal business name

WESLEY MANOR RETIREMENT COMMUNITY INC.

Practice address

5012 E Manslick Rd
Louisville, KY 40219-5165

Phone

(502) 969-3277

Fax

(502) 969-3270

NPI assigned

Dec 29, 2005

Last updated

Mar 7, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mark Gregory Stephens

Title

VP Admin Cfo

Phone

(502) 969-3277

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780661868. Details of each certification follow.

• CCN 185136 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 185136

Legal name

WESLEY MANOR RETIREMENT COMMUNITY INC.

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Apr 19, 1976

Last certification

Feb 25, 2022

Beds

68

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Aug 18, 1958 in KY

Enrollment address

5012 E Manslick Rd
Louisville, KY 40219-5165

Nursing home name

WESLEY MANOR

Listed as

Wesley ManorCCN 185136 · All quality measures

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

4 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Apr 19, 1976

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6857.2 residents per day on average

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

Tax ID family

Wesley Manor Nursing Home4 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.

• Wesley Manor Nursing Home

  • Occupational Therapist
  • Louisville, KY
  • NPI 1053587337
  NPD tax ID
• Wesley Manor Nursing Home

  • Physical Therapist
  • Louisville, KY
  • NPI 1427224708
  NPD tax ID
• Wesley Manor Nursing Home

  • Speech-Language Pathologist
  • Louisville, KY
  • NPI 1508032889
  NPD tax ID

All disclosed owners & managing parties 33

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

Owners & managing parties with NPI records 1

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

• Osawaru Jude Omoruyi, M.D

  • Family Medicine Physician
  • Louisville, KY
  • NPI 1396961967

  Adp of the SNF

  CMS ownership

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.

• Osawaru Jude Omoruyi, M.D

  • Family Medicine Physician
  • Louisville, KY
  • NPI 1396961967
  NPD (past)

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Osawaru Jude Omoruyi, M.D

  • Family Medicine Physician
  • Louisville, KY
  • NPI 1396961967

  Nursing home

  Care Compare affiliation
• Christopher M Smalley, MD

  • Family Medicine Physician
  • Louisville, KY
  • NPI 1326020272

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331078400000",
    "number": "1780661868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5012 E MANSLICK RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402195165",
            "telephone_number": "502-969-3277",
            "fax_number": "502-969-3270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5012 E MANSLICK RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402195165",
            "telephone_number": "502-969-3277",
            "fax_number": "502-969-3270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESLEY MANOR RETIREMENT COMMUNITY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-29",
        "last_updated": "2012-03-07",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "VP ADMIN CFO",
        "authorized_official_telephone_number": "502-969-3277",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "KY",
            "license": "100230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12500609",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Wernert, APRN
• Michele Nicole Werts, LCSW
• Wesley Manor Nursing Home
• Wesley Manor Nursing Home
• Wesley Manor Nursing Home
• Darrel P Wesley, CRNA
• Nadeja Dolores Wesley, LCSW
• Rebecca Wesseh, LPCA
• Caitlin Rae Wessel
• Paige Wessel, OTR/L

• Nursing Facility/Intermediate Care Facility in Louisville, KY
• Providers in Louisville, KY by specialty
• Nursing Facility/Intermediate Care Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.