Active NPI
Sayre Christian Village Nursing Home, Inc.
- Skilled Nursing Facility
- Lexington, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 100544
- Legal business name
- SAYRE CHRISTIAN VILLAGE NURSING HOME, INC.
- Practice address
- 3775 Belleau Wood Dr
Lexington, KY 40517-1804 - Phone
- (859) 271-9000
- Fax
- (859) 271-8160
- NPI assigned
- Jun 24, 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
- Dawn M Davis
- Title
- Business Office
- Phone
- (859) 271-9000
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 100544 | KY | Primary |
| Skilled Nursing Facility | 314000000X |
Addresses
Primary practice location
3775 Belleau Wood Dr
Lexington, KY 40517-1804
Mailing address
3775 Belleau Wood Dr
Lexington, KY 40517-1804
Phone (859) 271-9000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12501045 | Medicaid | KY |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Lexington | ||
| CONNECT URL | Lexington |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100211000086 | KY | Part A Provider - Skilled Nursing Facility | 2567505662 | Practice locations: Lexington, KY |
Skilled nursing facility certification: CCN 185248
- Legal name
- SAYRE CHRISTIAN VILLAGE NURSING HOME, INC.
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Mar 14, 1991
- Last certification
- Apr 24, 2025
- Beds
- 164
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Incorporated
- Dec 1, 1984 in KY
- Enrollment address
- 3775 Belleau Wood Dr
Lexington, KY 40517-1804 - Nursing home name
- SAYRE CHRISTIAN VILLAGE NURSING HOME
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Sayre Christian Village Nursing Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Mar 14, 1991
- Medicare certification status
- Active
- Certified beds
- 164
- Penalties (3 years)
- 2
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 |
|---|---|---|---|
| 18D0323551 | Sayre Christian Village Nursing Home | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & 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 |
|---|---|---|---|
| Ron Ring | Corporate Director | Jan 1, 2020 | 100% |
| Operational/Managerial Control | Mar 23, 2000 | ||
| J.L Lynn | Corporate Director | Apr 16, 1998 | |
| Operational/Managerial Control | Apr 16, 1998 | ||
| Mendy Pridemore | Corporate Officer | Nov 14, 2024 | |
| Operational/Managerial Control | Nov 14, 2024 | ||
| Adp of the SNF | Nov 14, 2024 | ||
| Benjamin Buckley | Corporate Director | Jan 1, 2020 | 100% |
| Operational/Managerial Control | Mar 24, 2016 | ||
| Evan Mossbarger | Corporate Director | Sep 28, 2023 | |
| Operational/Managerial Control | Sep 28, 2023 | ||
| Ben Allen | Corporate Director | Apr 28, 2022 | |
| Operational/Managerial Control | Apr 28, 2022 | ||
| Daniel Danford | Corporate Director | Nov 18, 2024 | |
| Operational/Managerial Control | Nov 18, 2024 | ||
| Janet Fey | Corporate Director | Jul 5, 2024 | |
| Operational/Managerial Control | Jul 5, 2024 | ||
| Jana Thore | Corporate Director | Nov 18, 2024 | |
| Operational/Managerial Control | Nov 18, 2024 | ||
| John W Richard | Adp of the SNF | Jan 1, 2020 | |
| Elise Hinchman | Corporate Officer | Feb 18, 2019 | |
| Operational/Managerial Control | Feb 18, 2019 | ||
| Adp of the SNF | Feb 18, 2019 | ||
| Darlene Herndon | Corporate Director | Jan 1, 2020 | 100% |
| Operational/Managerial Control | Jul 27, 2017 | ||
| Nancy Skiba | Corporate Director | May 22, 2014 | |
| Operational/Managerial Control | May 22, 2014 | ||
| Christian Benevolent Outreach, Inc. | Operational/Managerial Control | Jun 6, 1984 | |
| Adp of the SNF | Jun 6, 1984 | ||
| Penny M Upton | Corporate Officer | Jun 2, 2021 | 100% |
| Wayne Logan | Corporate Director | Apr 28, 2022 | |
| Operational/Managerial Control | Apr 28, 2022 | ||
| Heather Griffith | Corporate Officer | Feb 9, 2026 | |
| Operational/Managerial Control | Feb 9, 2026 | ||
| Adp of the SNF | Feb 9, 2026 | ||
| Kennetha Keinath | Corporate Director | Jan 1, 2020 | 100% |
| Operational/Managerial Control | Mar 24, 2016 | ||
| Gary Coleman | Corporate Director | Apr 16, 1998 | |
| Operational/Managerial Control | Apr 16, 1998 | ||
| Shane Smith | Corporate Officer | Dec 1, 2025 | |
| Operational/Managerial Control | Dec 1, 2025 | ||
| Adp of the SNF | Dec 1, 2025 | ||
| Vicki Philips | Corporate Officer | Jan 25, 2010 | |
| Operational/Managerial Control | Jan 25, 2010 | ||
| Adp of the SNF | Jan 25, 2010 | ||
| Karen L Venis | Corporate Officer | Jan 1, 2019 | 100% |
| Operational/Managerial Control | Sep 1, 2010 | ||
| Adp of the SNF | Sep 1, 2010 | ||
| John Dundon | Corporate Officer | Jan 1, 2022 | |
| Jerry Kelly | Corporate Director | Apr 26, 2007 | |
| Operational/Managerial Control | Apr 26, 2007 | ||
| Doug Flynn | Corporate Director | Jul 22, 2021 | |
| Operational/Managerial Control | Jul 22, 2021 | ||
| Tom Hurtz | Corporate Director | Mar 24, 2016 | |
| Operational/Managerial Control | Mar 24, 2016 | ||
| Jeffrey Yeary | Corporate Director | Apr 8, 2022 | |
| Operational/Managerial Control | Apr 8, 2022 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Lexington, KY
- NPI 1124047717
-
- Family Medicine Physician
- Lexington, KY
- NPI 1801059399
Affiliated clinicians 3
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": "1151107200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1581552000000",
"number": "1881620490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3775 BELLEAU WOOD DR",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405171804",
"telephone_number": "859-271-9000",
"fax_number": "859-271-8160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3775 BELLEAU WOOD DR",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405171804",
"telephone_number": "859-271-9000",
"fax_number": "859-271-8160"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAYRE CHRISTIAN VILLAGE NURSING HOME, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-24",
"last_updated": "2020-02-13",
"certification_date": "2020-02-13",
"status": "A",
"authorized_official_last_name": "DAVIS",
"authorized_official_first_name": "DAWN",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "BUSINESS OFFICE",
"authorized_official_telephone_number": "859-271-9000"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "KY",
"license": "100544",
"primary": true
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "12501045",
"state": "KY"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Lexington",
"affiliation": "N",
"address_1": "3775 Belleau Wood Dr",
"city": "Lexington",
"state": "KY",
"country_code": "US",
"postal_code": "405171804",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Lexington",
"affiliation": "N",
"address_1": "3775 Belleau Wood Dr",
"city": "Lexington",
"state": "KY",
"country_code": "US",
"postal_code": "405171804",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.