Active NPI
Oak Crest Village, Inc
- Skilled Nursing Facility
- Parkville, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 03-071
- Legal business name
- OAK CREST VILLAGE, INC
- Doing business as
- Oak Crest Village, Inc.
- Practice address
- 8832 Walther Blvd
Attn: Extended Care Administrator
Parkville, MD 21234-9020 - Phone
- (410) 655-1000
- Fax
- (410) 204-7237
- NPI assigned
- Apr 6, 2006
- 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
- James K Walter
- Title
- Finance Director
- Phone
- (410) 402-2315
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 03-071 | MD | Primary |
Addresses
Primary practice location
8832 Walther Blvd
Attn: Extended Care Administrator
Parkville, MD 21234-9020
Mailing address
8820 Walther Blvd
Attn: Executive Director
Parkville, MD 21234-9025
Phone (410) 655-1000
Other names 1
- Oak Crest Village, Inc.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070305000297 | MD | Part A Provider - Skilled Nursing Facility | 5991773038 | Practice locations: Parkville, MD |
Skilled nursing facility certification: CCN 215308
- Legal name
- OAK CREST VILLAGE, INC.
- Doing business as
- OAK CREST VILLAGE INC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 5, 1997
- Last certification
- Sep 6, 2024
- Beds
- 80
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Incorporated
- Apr 21, 1994 in MD
- Enrollment address
- 8832 Walther Blvd
Attn Extended Care Administrator
Parkville, MD 21234-9020 - Nursing home name
- OAK CREST VILLAGE
- Affiliated entity
- ERICKSON SENIOR LIVING
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Oak Crest Home Health Agency
- Home Health Agency
- Parkville, MD
- NPI 1174558910
5991773038
-
dba Outpatient Rehabilitation Agency at Oak Crest
- Rehabilitation Clinic/Center
- Parkville, MD
- NPI 1922051218
5991773038
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Oak Crest Village
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Jun 5, 1997
- Medicare certification status
- Active
- Certified beds
- 80
- Chain
- Erickson Senior Living
- Penalties (3 years)
- 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 21D0970069 | Oak Crest Village Care Center | Certificate of waiver | Feb 2, 2028 |
National Provider Directory
National Provider Directory- Tax ID family
- Oak Crest Village Inc
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Oak Crest Home Health Agency
- Home Health Agency
- Parkville, MD
- NPI 1174558910
-
dba Outpatient Rehabilitation Agency at Oak Crest
- Rehabilitation Clinic/Center
- Parkville, MD
- NPI 1922051218
Ownership & related parties
All disclosed owners & managing parties 27
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 |
|---|---|---|---|
| Russel N Sharp | Corporate Director | Apr 1, 2023 | |
| Ian Brown | Corporate Director | Apr 1, 2023 | |
| National Senior Communities, Inc | 5% Or Greater Direct Ownership Interest | Jan 14, 2021 | 100% |
| Operational/Managerial Control | Jan 14, 2021 | ||
| Adp of the SNF | Jan 14, 2021 | ||
| William Pomeranz | Corporate Director | Apr 1, 2025 | |
| Michael Roskiewicz | Corporate Director | Apr 1, 2019 | |
| Patricia Brown | Corporate Director | Apr 1, 2022 | |
| Stephanie L Reel | Corporate Officer | Oct 27, 2021 | |
| Corporate Director | Apr 22, 2013 | ||
| Neal a Gantert | Corporate Officer | Apr 1, 2018 | |
| Operational/Managerial Control | Apr 1, 2018 | ||
| Adp of the SNF | Apr 1, 2018 | ||
| Mary D Colins | Corporate Officer | Apr 1, 2019 | |
| Corporate Director | Apr 1, 2018 | ||
| Daniel Tyler | Corporate Officer | Apr 1, 2025 | |
| Eileen G Erstad | Corporate Officer | Feb 15, 2007 | |
| Corporate Director | Feb 15, 2007 | ||
| Mary Moscato | Corporate Director | Apr 1, 2024 | |
| Monty C Leonard | Corporate Officer | Apr 1, 2023 | |
| Corporate Director | Apr 1, 2022 | ||
| Daniel Wallick | Corporate Director | Apr 1, 2025 | |
| Pamela Paulk | Corporate Director | Apr 1, 2022 | |
| Ronald D. Jeffreys | Operational/Managerial Control | Aug 12, 2018 | |
| Adp of the SNF | Mar 11, 2025 | ||
| Richard Elwood | Corporate Director | Apr 1, 2025 | |
| Justin a Wolf | Operational/Managerial Control | Sep 17, 2023 | |
| Adp of the SNF | Sep 17, 2023 | ||
| Erickson Senior Living LLC | Operational/Managerial Control | Nov 23, 2020 | 100% |
| Adp of the SNF | Feb 12, 2025 | ||
| Christian Sweetser | Operational/Managerial Control | Mar 1, 2022 | |
| Adp of the SNF | Mar 1, 2022 | ||
| John Hall | Corporate Officer | Apr 30, 2010 | |
| Operational/Managerial Control | Apr 30, 2010 | ||
| Adp of the SNF | Apr 30, 2010 | ||
| Katherine L Clupper | Corporate Director | Apr 1, 2024 | |
| Zina Jacque | Corporate Director | Apr 1, 2018 | |
| Richard a Butler | Operational/Managerial Control | Jan 1, 2014 | |
| Scott R Sawicki | Corporate Officer | Apr 1, 2024 | |
| Mark D Embley | Corporate Officer | Oct 27, 2021 | |
| Operational/Managerial Control | Oct 27, 2021 | ||
| Adp of the SNF | Oct 27, 2021 | ||
| Pamela Stiner | Corporate Officer | Apr 1, 2024 | |
| Operational/Managerial Control | Apr 1, 2024 | ||
| Adp of the SNF | Apr 1, 2024 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Baltimore, MD
- NPI 1750347282
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 26
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Charlestown Care Center
- Skilled Nursing Facility
- Catonsville, MD
- NPI 1932166360
Erickson Senior Living LLC
-
dba Charlestown Home Health Agency
- Home Health Agency
- Catonsville, MD
- NPI 1992704068
Erickson Senior Living LLC
-
dba Oak Crest Home Health Agency
- Home Health Agency
- Parkville, MD
- NPI 1174558910
Erickson Senior Living LLC, National Senior Communities, Inc
-
- Skilled Nursing Facility
- Silver Spring, MD
- NPI 1730146929
Erickson Senior Living LLC, National Senior Communities, Inc
-
dba Riderwood Home Health Agencey
- Home Health Agency
- Silver Spring, MD
- NPI 1801904149
Erickson Senior Living LLC, National Senior Communities, Inc
-
dba Ann's Choice
- Skilled Nursing Facility
- Warminster, PA
- NPI 1114096773
Erickson Senior Living LLC, National Senior Communities, Inc
-
dba Ann's Choice Visiting Nurse Service
- Home Health Agency
- Warminster, PA
- NPI 1952489254
Erickson Senior Living LLC, National Senior Communities, Inc
-
dba Continuing Care at Ashby Ponds
- Skilled Nursing Facility
- Ashburn, VA
- NPI 1871831222
Erickson Senior Living LLC, National Senior Communities, Inc
-
dba Brooksby Visiting Nurse Service
- Home Health Agency
- Peabody, MA
- NPI 1679696835
Erickson Senior Living LLC, National Senior Communities, Inc
-
dba Continuing Care at Brooksby Village
- Skilled Nursing Facility
- Peabody, MA
- NPI 1780663336
Erickson Senior Living LLC, National Senior Communities, Inc
-
dba Continuing Care at Cedar Crest Village
- Skilled Nursing Facility
- Pompton Plains, NJ
- NPI 1427015882
Erickson Senior Living LLC, National Senior Communities, Inc
-
dba Cedar Crest Village, Inc., Home Health Department
- Home Health Agency
- Pompton Plains, NJ
- NPI 1790855567
Erickson Senior Living LLC, National Senior Communities, Inc
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Westminster, MD
- NPI 1942762604
-
- Internal Medicine Physician
- Baltimore, MD
- NPI 1750347282
Affiliated clinicians 6
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Internal Medicine) Physician
- Parkville, MD
- NPI 1871798223
Nursing home
-
- Geriatric Medicine (Family Medicine) Physician
- Parkville, MD
- NPI 1952341695
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144281600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1421798400000",
"number": "1871555490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8820 WALTHER BLVD",
"address_2": "ATTN: EXECUTIVE DIRECTOR",
"city": "PARKVILLE",
"state": "MD",
"postal_code": "212349025",
"telephone_number": "410-655-1000",
"fax_number": "410-204-7237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8832 WALTHER BLVD",
"address_2": "ATTN: EXTENDED CARE ADMINISTRATOR",
"city": "PARKVILLE",
"state": "MD",
"postal_code": "212349020",
"telephone_number": "410-655-1000",
"fax_number": "410-204-7237"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OAK CREST VILLAGE, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-06",
"last_updated": "2015-01-21",
"status": "A",
"authorized_official_last_name": "WALTER",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "FINANCE DIRECTOR",
"authorized_official_telephone_number": "410-402-2315"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MD",
"license": "03-071",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Oak Crest Village, Inc.",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Parkville, MD
- David A Nunez, LCSW-C
- Kimberly Nunez, OTR/L
- Leylah Sabriah Nur, LMSW
- Janemaureen Nneka Nweke
- Elizabeth O'Hara
- Oak Crest Village, Inc. (Oak Crest Home Health Agency)
- Oak Crest Village, Inc.
- Oak Crest Village, Inc. (Outpatient Rehabilitation Agency at Oak Crest)
- Oakcrest Village (skilled nursing fac.)
- Ashley Oakes, LCSW-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; 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.