WAVERLY CARE CENTER, INC (NPI# 1962508069) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962508069 |
| Entity Type | Organization |
| Organization Name | WAVERLY CARE CENTER, INC |
| Other Organization Name | NATIONAL CHURCH RESIDENCES BRISTOL VILLAGE |
| Practice Address |
444 Cherry St Waverly OH 45690 |
| Mailing Address |
2335 N Bank Dr Columbus OH 43220-5423 |
| Practice Telephone | 7409472113 |
| Practice Fax Number | 7409471854 |
| Mailing Telephone | 6144512151 |
| Mailing Fax Number | 6144427040 |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2019-06-27 |
| Authorized Official Name | TANYA K HAHN (VICE PRESIDENT) |
| Authorized Official Telephone | 6144512151 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 310400000X | Assisted Living Facility | OHL5001289 | OH | Nursing & Custodial Care Facilities |
| Y | 314000000X | Skilled Nursing Facility | 4884 | OH | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | ODH NURSING HOME LICENSE | 1910N | 01 |
| OH | 0770116 | 05 |
| Other Name | Type Code |
|---|---|
| National Church Residences Bristol Village | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851859953 | Waverly Care Center, Inc | Assisted Living Facility | 444 Cherry St, Waverly, OH 45690-1277 | 2019-03-07 |
| Street Address |
444 CHERRY ST |
| City | WAVERLY |
| State | OH |
| Zip Code | 45690 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851859953 | Waverly Care Center, Inc | Assisted Living Facility | 444 Cherry St, Waverly, OH 45690-1277 | 2019-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538767181 | Brandie Mustard | Homemaker | 3018 My Tabor Rd, Waverly, OH 45690 | 2020-10-15 |
| 1225661168 | Kyle Colley | Counselor | 14574 Us Hughway 23, Waverly, OH 45690 | 2020-02-19 |
| 1366082513 | Ryan Rawlins | Counselor | 14574 St. Rt. 23, Waverly, OH 45690 | 2020-01-15 |
| 1700424140 | Jaime Wooldridge | Counselor | 14532 St. Rt. 23, Waverly, OH 45690 | 2019-12-17 |
| 1518513415 | Jacquelyn Irene Sprouse | Counselor | 217 Emmitt Ave, Waverly, OH 45690 | 2019-08-15 |
| 1639634850 | Krista K Leeth | Counselor | 14532 Us Hwy 23, 14534 Us Hwy 23, Waverly, OH 45690 | 2019-02-01 |
| 1881196244 | Kevin Michael Reichert | Counselor | Pike County Recovery Council, 218 East North Street, Waverly, OH 45690 | 2018-03-01 |
| 1619483179 | Ticia Lewis | Counselor | 14532 State Route 23, Waverly, OH 45690 | 2017-12-20 |
| 1205342136 | Criston B Evans | Licensed Practical Nurse | 14532 Us Highway 23, Waverly, OH 45690 | 2017-12-14 |
| 1447763313 | Jody Ryan Colley | Counselor | 14572 St. Rt. 23, Waverly, OH 45690 | 2017-11-14 |
| Find all providers in zip 45690 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871606590 | Medical Facilities of America L | Skilled Nursing Facility | 456 East Main Street, Waverly, VA 23890-3237 | 2006-08-16 |
| 1134157191 | Waverly 1 Inc | Skilled Nursing Facility | 100 West Thomas Drive, Waverly, MO 64096-9143 | 2006-06-29 |
| 1871549592 | Five Star Quality Care-ne LLC | Skilled Nursing Facility | 11041 N 137th St, Waverly, NE 68462-1022 | 2006-05-25 |
| 1730145822 | Waverly Health Care and Rehabilitation Center Inc | Skilled Nursing Facility | 895 Powers Blvd, Waverly, TN 37185 | 2006-04-26 |
| 1255308094 | Northeast Medical & Oxygen | Skilled Nursing Facility | 2 Glenview Lane, Northeast Medical & Oxygen, Waverly, PA 18471 | 2006-03-01 |
| 1013904432 | Bartels Lutheran Home | Skilled Nursing Facility | 1922 5th Ave Nw, Waverly, IA 50677-1903 | 2005-09-30 |
| 1386641199 | Tioga Nursing Home | Skilled Nursing Facility | 37 N Chemung St, Waverly, NY 14892-1211 | 2005-07-07 |
| 1669033072 | Bcp Waverly, LLC | Skilled Nursing Facility | 11041 N 137th St, Waverly, NE 68462-1022 | 2019-06-26 |
| 1073937975 | Tina Rogers | Skilled Nursing Facility | 11041 N 137th St, Waverly, NE 68462-1022 | 2014-02-12 |
| 1891068565 | 37 North Chemung Street Operating Company LLC | Skilled Nursing Facility | 37 N Chemung St, Waverly, NY 14892-1211 | 2012-02-10 |
| Find all providers in WAVERLY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.