Active NPI
The Ball Pavilion
- Skilled Nursing Facility
- Erie, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 540302
- Legal business name
- THE BALL PAVILION
- Practice address
- 5416 E Lake Rd
Erie, PA 16511-1427 - Phone
- (814) 899-8600
- Fax
- (814) 898-1910
- NPI assigned
- Nov 1, 2005
- 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
- Mr. George William Hunter
- Title
- President Bvfi
- Phone
- (814) 899-8600
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 540302 | PA | Primary |
Addresses
Primary practice location
5416 E Lake Rd
Erie, PA 16511-1427
Mailing address
5416 E Lake Rd
Erie, PA 16511-1427
Phone (814) 899-8600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0007479270001 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120507000152 | PA | Part A Provider - Skilled Nursing Facility | 1557523677 | Practice locations: Erie, PA |
Skilled nursing facility certification: CCN 395401
- Legal name
- THE BALL PAVILION
- Doing business as
- THE BALL PAVILION
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Dec 1, 1978
- Last certification
- Mar 21, 2025
- Beds
- 85
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Incorporated
- Aug 7, 1975 in PA
- Enrollment address
- 5416 East Lake Road
Erie, PA 16511-1496 - Nursing home name
- BALL PAVILION, THE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Ball Pavilion, The
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Dec 1, 1978
- Medicare certification status
- Active
- Certified beds
- 85
National Provider Directory
National Provider Directory- Tax ID family
- Ball Pavilion
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Rehabilitation Hospital Unit
- Erie, PA
- NPI 1457679722
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Amy M Learn | Corporate Director | Apr 4, 2022 | |
| Adp of the SNF | Apr 4, 2022 | ||
| Brevillier Village Foundation Inc | Operational/Managerial Control | Jul 1, 1987 | |
| Adp of the SNF | Jan 28, 2025 | ||
| The Ball Pavilion | 5% Or Greater Direct Ownership Interest | Dec 15, 1977 | 100% |
| Adp of the SNF | Dec 15, 1977 | ||
| James Hawryliw | Corporate Director | Mar 21, 2019 | |
| Trustee of the SNF | Mar 21, 2019 | ||
| Marquette Savings Bank | 5% Or Greater Mortgage Interest | Dec 14, 2023 | 43% |
| Susan Plizga | Corporate Director | Oct 27, 2022 | |
| Trustee of the SNF | Oct 27, 2022 | ||
| Jeffrey Wieser | Corporate Director | Apr 16, 1987 | |
| Operational/Managerial Control | Mar 1, 2014 | ||
| Adp of the SNF | Mar 1, 2014 | ||
| Richard Elberfeld | Corporate Director | Oct 19, 2023 | 16.66% |
| Trustee of the SNF | Oct 19, 2023 | ||
| Adp of the SNF | Jan 30, 2025 | ||
| William Fife | Corporate Director | Oct 28, 2021 | |
| Trustee of the SNF | Oct 28, 2021 | ||
| Gary D Faulhaber | Corporate Director | Oct 27, 2022 | |
| Trustee of the SNF | Oct 27, 2022 | ||
| Christine MC Clure | Corporate Director | Oct 19, 2021 | |
| Trustee of the SNF | Oct 19, 2021 |
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Occupational Therapist
- Erie, PA
- NPI 1093062283
-
- Family Medicine Physician
- Erie, PA
- NPI 1982040168
-
- Internal Medicine Physician
- Erie, PA
- NPI 1598753220
-
- Adult Medicine Physician
- Erie, PA
- NPI 1538165493
Affiliated clinicians 2
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": "1130803200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1891786604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5416 E LAKE RD",
"city": "ERIE",
"state": "PA",
"postal_code": "165111427",
"telephone_number": "814-899-8600",
"fax_number": "814-898-1910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5416 E LAKE RD",
"city": "ERIE",
"state": "PA",
"postal_code": "165111427",
"telephone_number": "814-899-8600",
"fax_number": "814-898-1910"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE BALL PAVILION",
"organizational_subpart": "NO",
"enumeration_date": "2005-11-01",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "HUNTER",
"authorized_official_first_name": "GEORGE",
"authorized_official_middle_name": "WILLIAM",
"authorized_official_title_or_position": "PRESIDENT BVFI",
"authorized_official_telephone_number": "814-899-8600",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "PA",
"license": "540302",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0007479270001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.