NPIMap

Organization Active NPI

Lutheran Home-Winston-Salem, Inc.

Doing business as Trinity Glen

  • Skilled Nursing Facility
  • Winston Salem, NC
National Provider Identifier
1912902230
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH0058 Issued in NC
Legal business name
LUTHERAN HOME-WINSTON-SALEM, INC.
Doing business as
Trinity Glen
Practice address
849 Waterworks Rd
Winston Salem, NC 27101-1956
Phone
(336) 595-2166
Fax
(336) 595-2169
NPI assigned
Jun 14, 2005
Last updated
Feb 4, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Authorized official

Name
Ted Goins
Title
President
Phone
(704) 637-2870

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH0058 NC Primary

Addresses

Primary practice location

849 Waterworks Rd
Winston Salem, NC 27101-1956

Mailing address

5350 Old Walkertown Rd
Winston-Salem, NC 27105-2060
Phone (336) 595-2166

Other identifiers 1

IdentifierTypeStateIssuer
3415088MedicaidNC

Other names 1

  • Trinity Glen Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040902000803 NC Part A Provider - Skilled Nursing Facility 9133195092 Practice locations: Winston-Salem, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912902230. Details of each certification follow.

Skilled nursing facility certification: CCN 345088

Legal name
LUTHERAN HOME-WINSTON-SALEM, INC.
Doing business as
LUTHERAN HOME - WINSTON SALEM
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 1, 1973
Last certification
Jan 24, 2025
Beds
117
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 4, 1985 in NC
Enrollment address
849 Waterworks Road
Winston-Salem, NC 17101-1956
Nursing home name
TRINITY GLEN
Affiliated entity
LUTHERAN SERVICES CAROLINAS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Trinity GlenCCN 345088 · 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
Apr 1, 1973
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
117107.0 residents per day on average
Chain
Lutheran Services Carolinas9 facilities in the chain

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
34D0700768Trinity Glen849 Waterworks Road, Winston Salem, NC 27101Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

5350 Old Walkertown Rd
Winston Salem, NC 27105
Phone (336) 595-2166

849 Waterworks Rd
Winston Salem, NC 27101
Phone (336) 559-2166

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Kesha L Smith Individual Corporate DirectorCoo Oct 1, 2012
Operational/Managerial Control Oct 1, 2012
Adp of the SNF Oct 1, 2012
Richard Herman Individual Managing Control - Governing BodyTrustee/Vice Chair Jun 1, 2021
Trustee of the SNF Jun 1, 2021
Ted W Goins Individual Operational/Managerial Control Oct 1, 2004
Managing Control - Governing BodyCeo /President Oct 1, 2004
Trustee of the SNF Oct 1, 2004
Christopher M Herman Individual Operational/Managerial Control Jun 20, 2023
Adp of the SNF Jun 20, 2023
Douglas E Nelson Individual Managing Control - Governing BodyTrustee/Chair Sep 1, 2022
Trustee of the SNF Sep 1, 2022
Lutheran Home Winston Salem Property Inc. Organization, Winston Salem, NC Corporation, Non-profit Operational/Managerial Control Jul 18, 2006
Adp of the SNF Apr 14, 2025
Karen Maddry Individual Corporate OfficerSecretary Apr 30, 2007
Managing Control - Governing BodySecreatry Apr 30, 2007
Lutheran Services for the Aging, Inc. Organization, Salisbury, NC Corporation, Non-profit 5% Or Greater Direct Ownership Interest Oct 1, 2004 100%
Trustee of the SNF Oct 1, 2004
Kirby Nickerson Individual Corporate OfficerCfo Oct 1, 2012
Operational/Managerial Control Jun 25, 2012
Managing Control - Governing BodyOfficer Oct 1, 2012
Trustee of the SNF Oct 1, 2012
Adp of the SNF Oct 1, 2012
Lsa Management, Inc. Organization, Salisbury, NC Non-profit Operational/Managerial Control Jul 29, 2004
Adp of the SNF Apr 14, 2025
Logan Wilmouth Individual Operational/Managerial Control Jun 24, 2023
Adp of the SNF Jun 24, 2023

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 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.

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": "1118707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770163200000",
    "number": "1912902230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 OLD WALKERTOWN RD",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271052060",
            "telephone_number": "336-595-2166",
            "fax_number": "336-595-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "849 WATERWORKS RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271011956",
            "telephone_number": "336-595-2166",
            "fax_number": "336-595-2169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN HOME-WINSTON-SALEM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-14",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A",
        "authorized_official_last_name": "GOINS",
        "authorized_official_first_name": "TED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-637-2870"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3415088",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Glen",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.