NPIMap

Organization Active NPI

Virginia Health Services, Inc

Doing business as Walter Reed Convalescent and Rehabiliation Center

  • Skilled Nursing Facility
  • Gloucester, VA
National Provider Identifier
1871580753
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH2715 Issued in VA
Legal business name
VIRGINIA HEALTH SERVICES, INC
Doing business as
Walter Reed Convalescent and Rehabiliation Center
Practice address
7602 Meredith Dr
Gloucester, VA 23061-4151
Phone
(804) 693-6503
Fax
(804) 693-6412
NPI assigned
Oct 5, 2005
Last updated
Aug 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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

Authorized official

Name
Mrs. Nicole Leigh Boldy
Title
Cfo
Phone
(757) 599-7422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH2715 VA Primary

Addresses

Primary practice location

7602 Meredith Dr
Gloucester, VA 23061-4151

Mailing address

240 Nat Turner Blvd S
Newport News, VA 23606-0020
Phone (757) 596-6268

Other identifiers 2

IdentifierTypeStateIssuer
227539OtherVAANTHEM
004952766MedicaidVA

Other names 1

  • Walter Reed Convalescent and Rehabiliation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100720000762 VA Part A Provider - Skilled Nursing Facility 3072422708 Practice locations: Gloucester, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1871580753. Details of each certification follow.

Skilled nursing facility certification: CCN 495276

Legal name
VIRGINIA HEALTH SERVICES, INC
Doing business as
WALTER REED NURSING AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 1, 1993
Last certification
Aug 22, 2024
Beds
181
Ownership / control type
Corporation
Multi-facility organization
Virginia Health Services
Most recent change of ownership
Sep 11, 2025
Organization structure
CorporationProprietary
Incorporated
Mar 21, 1980 in VA
Enrollment address
7602 Meredith Drive
Gloucester, VA 23061-4151

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Walter Reed Post AcuteCCN 495276 · All quality measures
Overall star rating
4 of 5
Health inspections
5 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
May 1, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
181166.1 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Robert E Walters Individual W-2 Managing EmployeeVP of Clinical Operations Oct 14, 2013
Mark F Klyczek Individual Corporate OfficerPresident/Ceo Apr 1, 2020
Corporate DirectorPresident/Ceo Apr 1, 2020
W-2 Managing EmployeePresident/Ceo Apr 1, 2020
Fulton Bank, N.a. Organization, Lancaster, PA Financial institution 5% Or Greater Mortgage Interest Mar 1, 2013 45%
Harry Henderson Wason Individual Corporate OfficerSecretary Nov 24, 2014
Corporate Director Jan 1, 2003
Donald Lundin Individual W-2 Managing EmployeeVice President of Operations Mar 1, 2021
Stephen Morrisette Individual Corporate DirectorBoard Member Jan 1, 2015
George S Mitchell Jr Rvoc TR Organization, Newport News, VA 5% Or Greater Direct Ownership Interest Nov 20, 2020 6.52%
Harry Henderson Wason Individual 5% Or Greater Direct Ownership Interest Jan 1, 2012 9.18%
Raymond Suttle Individual Corporate Director Jan 1, 2003
Nicole Boldy Individual Corporate OfficerChief Financial Officer Jul 1, 2020
W-2 Managing EmployeeChief Financial Officer Jan 1, 2009
Robert Freeman Individual Corporate OfficerChairman of the Board Jan 1, 2003
Corporate Director Jan 1, 2003
Bryant Hudgins Individual W-2 Managing EmployeeAdministrator May 20, 2019

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 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1128470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598572800000",
    "number": "1871580753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 NAT TURNER BLVD S",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236060020",
            "telephone_number": "757-596-6268",
            "fax_number": "757-595-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7602 MEREDITH DR",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230614151",
            "telephone_number": "804-693-6503",
            "fax_number": "804-693-6412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-05",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A",
        "authorized_official_last_name": "BOLDY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "757-599-7422",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "VA",
            "license": "NH2715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "227539",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004952766",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walter Reed Convalescent and Rehabiliation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Walter Reed Convalescent and Rehabiliation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gloucester, VA

Sources for this page

Verify at the official NPI Registry.