NPIMap

Organization Active NPI

Waverly Care Center, Inc

Doing business as National Church Residences Bristol Village

  • Skilled Nursing Facility
  • Waverly, OH
National Provider Identifier
1962508069
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
4884 Issued in OH
Legal business name
WAVERLY CARE CENTER, INC
Doing business as
National Church Residences Bristol Village
Practice address
444 Cherry St
Waverly, OH 45690
Phone
(740) 947-2113
Fax
(740) 947-1854
NPI assigned
Sep 15, 2006
Last updated
Oct 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Authorized official

Name
Brianna Mettler
Title
President
Phone
(614) 451-2151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 4884 OH Primary

Addresses

Primary practice location

444 Cherry St
Waverly, OH 45690

Mailing address

5475 Rings Rd Ste 300
Dublin, OH 43017-7537
Phone (614) 451-2151

Other identifiers 2

IdentifierTypeStateIssuer
1910NOtherOHODH NURSING HOME LICENSE
0770116MedicaidOH

Other names 1

  • National Church Residences Bristol Village Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090522000097 OH Part A Provider - Skilled Nursing Facility 9537251988 Practice locations: Waverly, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962508069. Details of each certification follow.

Skilled nursing facility certification: CCN 365742

Legal name
WAVERLY CARE CENTER INC
Doing business as
NATIONAL CHURCH RESIDENCES BRISTOL VILLAGE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 29, 1989
Last certification
Oct 9, 2024
Beds
40
Ownership / control type
Nonprofit Corporation
Multi-facility organization
National Church Residences
Organization structure
CorporationNon-profit
Incorporated
Dec 12, 1991 in OH
Enrollment address
444 Cherry St
Waverly, OH 45690-1277
Nursing home name
NATIONAL CHURCH RESIDENCES BRISTOL VILLAGE

Care Compare: Nursing home

Medicare Care Compare
Listed as
National Church Residences Bristol VillageCCN 365742 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jun 29, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4033.2 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Waverly Care Center Inc2 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 13

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

NameRoleSinceShare
Amy Clemmons Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jul 21, 2025
National Church Residences Organization, Dublin, OH Corporation, Non-profit 5% Or Greater Direct Ownership Interest Dec 12, 1991 100%
Matthew Rule Individual Corporate DirectorVice President Jan 1, 2021
Sean Alexander Individual Corporate DirectorVice President Jan 1, 2025
Lindsey Dehring Individual Corporate OfficerTreasurer Jul 1, 2024
Sonya Brown Individual Corporate DirectorBoard of Director Jan 1, 2025
Julie Woolley Individual Corporate OfficerSecretary May 1, 2021
Denise N. Anderson Individual Corporate DirectorBoard of Director Jan 1, 2025
David Kessler Individual Corporate DirectorMedical Director Mar 7, 2017
Adp of the SNF Jan 7, 2025
National Church Residences Health Care Organization, Dublin, OH Corporation, Management services company, Non-profit, Chain home office Operational/Managerial Control Jul 2, 2019
Adp of the SNF Jul 2, 2019
Kelli Meyung Individual Corporate DirectorVP Jul 1, 2024
Brianna Mettler Individual Corporate OfficerPresident Jan 1, 2020
Parker Stitzer Individual Corporate DirectorBoard of Director Jan 1, 2024

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 6

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

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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 4

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": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761696000000",
    "number": "1962508069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5475 RINGS RD STE 300",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430177537",
            "telephone_number": "614-451-2151",
            "fax_number": "614-442-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 CHERRY ST",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "45690",
            "telephone_number": "740-947-2113",
            "fax_number": "740-947-1854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVERLY CARE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A",
        "authorized_official_last_name": "METTLER",
        "authorized_official_first_name": "BRIANNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "614-451-2151"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "4884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ODH NURSING HOME LICENSE",
            "identifier": "1910N",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0770116",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "National Church Residences Bristol Village",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "National Church Residences Bristol Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waverly, OH

Sources for this page

Verify at the official NPI Registry.