Monongalia Home Corporation

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

23 Issued in WV

Legal business name

MONONGALIA HOME CORPORATION

Doing business as

Sundale Nursing Home

Practice address

800 J D Anderson Dr
Morgantown, WV 26505-3474

Phone

(304) 599-0497

Fax

(304) 599-9083

NPI assigned

Oct 16, 2006

Last updated

Mar 27, 2023By 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. Michael Wayne Hicks, N.H.A.

Title

Managing Agent

Phone

(304) 599-0497

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sundale Nursing Home Doing business as

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790865962. Details of each certification follow.

• CCN 515083 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 515083

Legal name

MONONGALIA HOME CORPORATION

Doing business as

SUNDALE NURSING HOME

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jun 15, 1988

Last certification

Jan 14, 2025

Beds

100

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Jan 28, 1958 in WV

Enrollment address

800 JD Anderson Drive
Morgantown, WV 26505-3474

Nursing home name

SUNDALE NURSING HOME

Listed as

Sundale Nursing HomeCCN 515083 · All quality measures

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

4 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Jun 15, 1988

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

10092.3 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

All disclosed owners & managing parties 17

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 2

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

• Carl Dean Shrader Jr., M.D., PH.D.

  • Family Medicine Physician
  • Morgantown, WV
  • NPI 1477870764

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• West Virginia University Medical Corporation

  dba University Health Associates

  • Family Medicine Physician
  • Morgantown, WV
  • NPI 1275504508

  Adp of the SNF, Operational/Managerial Control

  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.

• Carl Dean Shrader Jr., M.D., PH.D.

  • Family Medicine Physician
  • Morgantown, WV
  • NPI 1477870764
  NPD (past)

Affiliated clinicians 1

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

• Carl Dean Shrader Jr., M.D., PH.D.

  • Family Medicine Physician
  • Morgantown, WV
  • NPI 1477870764

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679875200000",
    "number": "1790865962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 J D ANDERSON DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053474",
            "telephone_number": "304-599-0497",
            "fax_number": "304-599-9083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 J D ANDERSON DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053474",
            "telephone_number": "304-599-0497",
            "fax_number": "304-599-9083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONONGALIA HOME CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "MANAGING AGENT",
        "authorized_official_telephone_number": "304-599-0497",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "N.H.A."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WV",
            "license": "23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790865962",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sundale Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sundale Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Monongalia County Health Department
• Monongalia County Society for Crippled Children and Adults (SteppingStones)
• Monongalia County Youth Service Center, Inc.
• Monongalia Emergency Medical Services Inc
• Monongalia Eye Clinic LLC
• Monongalia Orthopedic Foot and Ankle Center (Greschner Foot & Ankle Specialists)
• Monongalia Pediatric & Youth Associates, Inc.
• Monongalia Pediatric & Youth Associates, Inc.
• Monongalia Physical Therapy Services, LTD.
• Monongalia Radiology Associates, P.C.

• Skilled Nursing Facility in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Skilled Nursing Facility in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.