Organization Active NPI

Oak Crest Village, Inc

  • Skilled Nursing Facility
  • Parkville, MD
National Provider Identifier
1871555490
Registry record updated Jan 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
03-071 Issued in MD
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

Updated by the provider on Jan 21, 2015

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)CodeLicenseStatePrimary
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. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
CorporationNon-profit
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).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Oak Crest VillageCCN 215308 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jun 5, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8077.0 residents per day on average
Chain
Erickson Senior Living17 facilities in the chain
Penalties (3 years)
1Fines totaling $49,725

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D0970069Oak Crest Village Care Center8832 Walther Boulevard, Baltimore, MD 21234Certificate of waiverFeb 2, 2028

National Provider Directory

National Provider Directory
Tax ID family
Oak Crest Village Inc4 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 27

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%
Operational/Managerial Control Jan 14, 2021
Adp of the SNF Jan 14, 2021
William Pomeranz Individual Corporate DirectorBoard Member Apr 1, 2025
Michael Roskiewicz Individual Corporate DirectorBoard Member Apr 1, 2019
Patricia Brown Individual Corporate DirectorBoard Member Apr 1, 2022
Stephanie L Reel Individual Corporate OfficerChair & President Oct 27, 2021
Corporate DirectorBoard Member Apr 22, 2013
Neal a Gantert Individual Corporate OfficerAssistant Treasurer Apr 1, 2018
Operational/Managerial Control Apr 1, 2018
Adp of the SNF 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 OfficerTreasurer Feb 15, 2007
Corporate DirectorBoard Member Feb 15, 2007
Mary Moscato Individual Corporate DirectorBoard Member Apr 1, 2024
Monty C Leonard Individual Corporate OfficerVice Chair & Vice President Apr 1, 2023
Corporate DirectorBoard Member Apr 1, 2022
Daniel Wallick Individual Corporate DirectorBoard Member Apr 1, 2025
Pamela Paulk Individual Corporate DirectorBoard Member Apr 1, 2022
Ronald D. Jeffreys Individual Operational/Managerial Control Aug 12, 2018
Adp of the SNF Mar 11, 2025
Richard Elwood Individual Corporate DirectorBoard Member Apr 1, 2025
Justin a Wolf Individual Operational/Managerial Control Sep 17, 2023
Adp of the SNF Sep 17, 2023
Erickson Senior Living LLC Organization, Catonsville, MD LLC, Management services company, For-profit, Chain home office Operational/Managerial Control Nov 23, 2020 100%
Adp of the SNF Feb 12, 2025
Christian Sweetser Individual Operational/Managerial Control Mar 1, 2022
Adp of the SNF Mar 1, 2022
John Hall Individual Corporate OfficerAsst. Treasurer Apr 30, 2010
Operational/Managerial Control Apr 30, 2010
Adp of the SNF Apr 30, 2010
Katherine L Clupper Individual Corporate DirectorBoard Member Apr 1, 2024
Zina Jacque Individual Corporate DirectorBoard Member Apr 1, 2018
Richard a Butler Individual Operational/Managerial Control Jan 1, 2014
Scott R Sawicki Individual Corporate OfficerAssistant Secretary Apr 1, 2024
Mark D Embley Individual Corporate OfficerAssistant Treasurer Oct 27, 2021
Operational/Managerial Control Oct 27, 2021
Adp of the SNF Oct 27, 2021
Pamela Stiner Individual Corporate OfficerAssistant Treasurer 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.

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

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 6

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": "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

Sources for this page

Verify at the official NPI Registry.