Active NPI
Willow Brook Christian Services
Doing business as Cherith Care Center
- Skilled Nursing Facility
- Delaware, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 2085N3705
- Legal business name
- WILLOW BROOK CHRISTIAN SERVICES
- Doing business as
- Cherith Care Center
- Practice address
- 100 Willow Brook Way South
Delaware, OH 43015 - Phone
- (740) 369-0048
- Fax
- (740) 368-4630
- NPI assigned
- Jan 23, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Terry G Martini
- Title
- Finance Director
- Phone
- (740) 368-4621
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 2085N3705 | OH | Primary |
Addresses
Primary practice location
100 Willow Brook Way South
Delaware, OH 43015
Mailing address
100 Willow Brook Way South
Delaware, OH 43015
Phone (740) 369-0048
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2524138 | Medicaid | OH |
Other names 1
- Cherith Care Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050128000560 | OH | Part A Provider - Skilled Nursing Facility | 4486624970 | Practice locations: Delaware, OH |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1811967078. Details of each certification follow.
Skilled nursing facility certification: CCN 366246
- Legal name
- WILLOW BROOK CHRISTIAN SERVICES
- Doing business as
- CHERITH CARE CENTER AT WILLOW BROOK
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Aug 1, 2002
- Last certification
- May 28, 2025
- Beds
- 34
- Ownership / control type
- Church Related
- Multi-facility organization
- Willow Brook Christian Services
- Most recent change of ownership
- Jan 1, 2005
- Organization structure
- Corporation
- Incorporated
- Apr 12, 2004 in OH
- Enrollment address
- 100 Willow Brook S Way South
Delaware, OH 43015-3241 - Nursing home name
- CHERITH CARE CENTER AT WILLOW BROOK
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Willow Brook Christian Home
- Skilled Nursing Facility
- Columbus, OH
- NPI 1346210515
4486624970
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Cherith Care Center at Willow Brook
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Church related
- Certified
- Aug 1, 2002
- Medicare certification status
- Active
- Certified beds
- 34
National Provider Directory
National Provider DirectoryLocations
55 Lazelle Rd
Columbus, OH 43235
Phone (614) 885-3300
Ownership & related parties
All disclosed owners & managing parties 18
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Scott Longo | Corporate Director | Mar 10, 2007 | |
| Managing Control - Governing Body | Mar 10, 2007 | ||
| Nicole Ketron | Operational/Managerial Control | Jan 1, 2005 | |
| Adp of the SNF | Jan 1, 2005 | ||
| Dana Slingluff | Corporate Director | Mar 18, 2023 | |
| Managing Control - Governing Body | Mar 18, 2023 | ||
| Peter D Hucek | Adp of the SNF | Jun 13, 2018 | |
| Thomas Poulson | Corporate Officer | Jun 28, 2010 | |
| Operational/Managerial Control | Jun 28, 2010 | ||
| Adp of the SNF | Jun 28, 2010 | ||
| Kim Johnson | Corporate Director | Nov 14, 2019 | |
| Managing Control - Governing Body | Nov 14, 2019 | ||
| Matthew Troy McKnight | Corporate Officer | Jan 9, 2023 | |
| Operational/Managerial Control | Jan 9, 2023 | ||
| Adp of the SNF | Jan 9, 2023 | ||
| Jason Dulgar | Corporate Director | Nov 13, 2023 | |
| Managing Control - Governing Body | Nov 13, 2023 | ||
| Terry Lee Irwin | Corporate Director | Jan 1, 2005 | |
| Managing Control - Governing Body | Jan 1, 2005 | ||
| William Johnson | Corporate Director | Nov 14, 2019 | |
| Managing Control - Governing Body | Nov 14, 2019 | ||
| Brandi Davis | Corporate Director | Jan 11, 2024 | |
| Managing Control - Governing Body | Jan 11, 2024 | ||
| Blythe McKenna | Corporate Director | Jan 23, 2025 | |
| Managing Control - Governing Body | Jan 23, 2025 | ||
| Judy March | Corporate Director | Aug 10, 2017 | |
| Managing Control - Governing Body | Aug 10, 2017 | ||
| Roger Pickens | Corporate Director | Nov 8, 2012 | |
| Managing Control - Governing Body | Nov 8, 2012 | ||
| Peggy Tidwell | Corporate Director | Mar 16, 2013 | |
| Managing Control - Governing Body | Mar 16, 2013 | ||
| Ed Sarkel | Corporate Director | May 9, 2019 | |
| Managing Control - Governing Body | May 9, 2019 | ||
| Karen Susenna | Corporate Director | Nov 9, 2017 | |
| Managing Control - Governing Body | Nov 9, 2017 | ||
| Phil Barth | Corporate Director | Jan 1, 2005 | |
| Managing Control - Governing Body | Jan 1, 2005 |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Columbus, OH
- NPI 1699866160
Corporate Director, Managing Control - Governing Body
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.
-
- Family Medicine Physician
- Granville, OH
- NPI 1548274871
Affiliated clinicians 2
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": "1137974400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1811967078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 WILLOW BROOK WAY SOUTH",
"city": "DELAWARE",
"state": "OH",
"postal_code": "43015",
"telephone_number": "740-369-0048",
"fax_number": "740-368-4630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 WILLOW BROOK WAY SOUTH",
"city": "DELAWARE",
"state": "OH",
"postal_code": "43015",
"telephone_number": "740-369-0048",
"fax_number": "740-368-4630"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WILLOW BROOK CHRISTIAN SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2006-01-23",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "MARTINI",
"authorized_official_first_name": "TERRY",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "FINANCE DIRECTOR",
"authorized_official_telephone_number": "740-368-4621",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "OH",
"license": "2085N3705",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2524138",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Cherith Care Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Delaware, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.