NPIMap

Organization Active NPI

Riderwood Village, Inc.

  • Home Health Agency
  • Silver Spring, MD
National Provider Identifier
1801904149
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HH7056 Issued in MD
Legal business name
RIDERWOOD VILLAGE, INC.
Practice address
3120 Gracefield Road
Attn: Home Health Administrator
Silver Spring, MD 20904-5810
Phone
(301) 572-1300
Fax
(410) 204-7237
NPI assigned
Aug 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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

Authorized official

Name
James K Walter
Title
Finacne Director
Phone
(410) 402-2315

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HH7056 MD Primary

Addresses

Primary practice location

3120 Gracefield Road
Attn: Home Health Administrator
Silver Spring, MD 20904-5810

Mailing address

3140 Gracefield Road
Attn: Executive Director
Silver Spring, MD 20904-1820
Phone (301) 572-1300

Other names 1

  • Riderwood Home Health Agencey Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070615000309 MD Part A Provider - Home Health Agency 4183611437 Practice locations: Silver Springs, MD

Home health agency certification: CCN 217156

Legal name
RIDERWOOD VILLAGE, INC.
Doing business as
RIDERWOOD HOME HEALTH AGENCY
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 21, 2006
Last certification
Jan 26, 2021
Ownership / control type
Proprietary
Organization structure
CorporationNon-profit
Incorporated
Jun 26, 1998 in MD
Enrollment address
3120 Gracefiled Road
Attn Home Health Administrator
Silver Springs, MD 20904-5810
HHA Branch

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Riderwood Village, Inc.CCN 217156
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Feb 21, 2006
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Outpatient Rehabilitation Agency at Riderwood Village4 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.

Ownership & related parties

All disclosed owners & managing parties 25

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

NameRoleSinceShare
Russel N Sharp Individual Corporate DirectorBoard Member Apr 1, 2023
Ian Brown Individual Corporate DirectorBoard Member Apr 1, 2023
National Senior Communities, Inc Organization, Catonsville, MD Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 14, 2021 100%
William Pomeranz Individual Corporate DirectorBoard Member Apr 1, 2025
Deidra E Gray-Weaver Individual Contracted Managing EmployeeExecutive Director May 9, 2022
Linda W Wanner Individual Corporate DirectorBoard Member Apr 1, 2023
Michael Roskiewicz Individual Corporate DirectorBoard Member Apr 1, 2019
Patricia Brown Individual Corporate OfficerChair & President Apr 1, 2023
Corporate DirectorBoard Member Apr 1, 2022
Stephanie L Reel Individual Corporate DirectorBoard Member Apr 22, 2013
Neal a Gantert Individual Contracted Managing EmployeeVP, Regional Finance Apr 1, 2018
Corporate OfficerAssistant Treasurer Apr 1, 2018
Mary D Colins Individual Corporate OfficerSecretary Apr 1, 2019
Corporate DirectorBoard Member Apr 1, 2018
Daniel Tyler Individual Corporate OfficerAssistant Treasurer Apr 1, 2025
Eileen G Erstad Individual Corporate OfficerVice Chair/Vice President/Treasurer Apr 1, 2023
Corporate DirectorBoard Member Feb 15, 2007
Mary Moscato Individual Corporate DirectorBoard Member Apr 1, 2024
Monty C Leonard Individual Corporate DirectorBoard Member Apr 1, 2022
Daniel Wallick Individual Corporate DirectorBoard Member Apr 1, 2025
Pamela Paulk Individual Corporate DirectorBoard Member Apr 1, 2022
Erickson Senior Living LLC Organization, Catonsville, MD LLC Operational/Managerial Control Nov 23, 2020 100%
Christian Sweetser Individual Contracted Managing EmployeeCfo Mar 1, 2022
John Hall Individual Contracted Managing EmployeeVP Finance Apr 30, 2010
Corporate OfficerAssistant Treasurer Apr 30, 2010
Katherine L Clupper Individual Corporate DirectorBoard Member Apr 1, 2024
Zina Jacque Individual Corporate DirectorBoard Member Apr 1, 2018
Scott R Sawicki Individual Corporate OfficerAssistant Secretary Apr 1, 2024
Mark D Embley Individual Contracted Managing EmployeeVP, Regional Finance Oct 27, 2021
Corporate OfficerAssistant Treasurer Oct 27, 2021
Pamela Stiner Individual Contracted Managing EmployeeVP, Regional Finance Apr 1, 2024
Corporate OfficerAssistant Treasurer Apr 1, 2024

Facilities with the same owner 26

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

View all 26

Practitioners & affiliated clinicians

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": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329955200000",
    "number": "1801904149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 GRACEFIELD ROAD",
            "address_2": "ATTN: EXECUTIVE DIRECTOR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041820",
            "telephone_number": "301-572-1300",
            "fax_number": "410-204-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 GRACEFIELD ROAD",
            "address_2": "ATTN: HOME HEALTH ADMINISTRATOR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209045810",
            "telephone_number": "301-572-1300",
            "fax_number": "410-204-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDERWOOD VILLAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2012-02-23",
        "status": "A",
        "authorized_official_last_name": "WALTER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "FINACNE DIRECTOR",
        "authorized_official_telephone_number": "410-402-2315"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MD",
            "license": "HH7056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riderwood Home Health Agencey",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.