NPIMap

Organization Active NPI

Vancrest of New Carlisle, LLC

  • Skilled Nursing Facility
  • New Carlisle, OH
National Provider Identifier
1871839167
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
VANCREST OF NEW CARLISLE, LLC
Practice address
1885 N Dayton Lakeview Rd
New Carlisle, OH 45344-8292
Phone
(937) 845-8219
Fax
(937) 845-2404
NPI assigned
Dec 14, 2012
Last updated
May 19, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

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

Authorized official

Name
Kyle Holliday
Title
Asst Cfo
Phone
(419) 238-0715

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X OH Primary

Addresses

Primary practice location

1885 N Dayton Lakeview Rd
New Carlisle, OH 45344-8292

Mailing address

120 W Main St Ste 200
Van Wert, OH 45891-1761
Phone (419) 238-0715

Other identifiers 1

IdentifierTypeStateIssuer
0077576MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130227000004 OH Part A Provider - Skilled Nursing Facility 8022263953 Practice locations: New Carlisle, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1871839167. Details of each certification follow.

Skilled nursing facility certification: CCN 366108

Legal name
VANCREST OF NEW CARLISLE LLC
Doing business as
VANCREST OF NEW CARLISLE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 9, 1997
Last certification
Feb 16, 2023
Beds
86
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Vancrest Health Care Centers
Organization structure
LLCProprietary
Incorporated
Oct 19, 2012 in OH
Enrollment address
1885 N Dayton Lakeview Rd
New Carlisle, OH 45344-9101
Nursing home name
VANCREST OF NEW CARLISLE
Affiliated entity
VANCREST HEALTH CARE CENTERS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Vancrest of New CarlisleCCN 366108 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 9, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8677.8 residents per day on average
Chain
Vancrest Health Care Centers13 facilities in the chain
Penalties (3 years)
1Fines totaling $0

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Vancrest of New Carlisle2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Vancrest Management Corp. Organization, Van Wert, OH Management services company Operational/Managerial Control Jan 1, 2013 74%
Jon D Bagley Individual 5% Or Greater Direct Ownership Interest Jan 1, 2013 22%
Jacob D Gehl Individual 5% Or Greater Direct Ownership Interest Jan 1, 2013 10%
Mark Stuart McCleery Individual 5% Or Greater Direct Ownership Interest Jan 1, 2013 9%
Carol L White Individual 5% Or Greater Direct Ownership Interest Jan 1, 2013 8%
Steven Edward White Individual 5% Or Greater Direct Ownership Interest Jan 1, 2013 8%
Mark a White Individual 5% Or Greater Direct Ownership Interest Jan 1, 2013 27%
Shane Stewart Individual Corporate OfficerCoo Sep 23, 2019
Operational/Managerial Control Sep 23, 2019
Adp of the SNF Sep 23, 2019
Mark L Myers Individual 5% Or Greater Direct Ownership Interest Jan 1, 2013 16%

Facilities with the same owner 8

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

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1355443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779148800000",
    "number": "1871839167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W MAIN ST STE 200",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458911761",
            "telephone_number": "419-238-0715",
            "fax_number": "419-238-4814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1885 N DAYTON LAKEVIEW RD",
            "city": "NEW CARLISLE",
            "state": "OH",
            "postal_code": "453448292",
            "telephone_number": "937-845-8219",
            "fax_number": "937-845-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANCREST OF NEW CARLISLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-14",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A",
        "authorized_official_last_name": "HOLLIDAY",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "ASST CFO",
        "authorized_official_telephone_number": "419-238-0715"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0077576",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Carlisle, OH

Sources for this page

Verify at the official NPI Registry.