LUTHERAN HOME FOR THE AGED (NPI# 1891792354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891792354 |
| Entity Type | Organization |
| Organization Name | LUTHERAN HOME FOR THE AGED |
| Other Organization Name | THE VILLAGE AT LUTHER SQUARE |
| Practice Address |
149 W 22nd St Erie PA 16502-2804 |
| Practice Telephone | 8144523271 |
| Practice Fax Number | 8144560383 |
| Mailing Telephone | 8144523271 |
| Mailing Fax Number | 8144560383 |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2011-01-03 |
| Authorized Official Name | MR. MARK J. GUSEK (C EO) |
| Authorized Official Telephone | 8144523271 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 382602 | PA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | BLUE CROSS PROVIDER NO. | 0648 | 01 |
| PA | 1007767250002 | 05 |
| Other Name | Type Code |
|---|---|
| The Village at Luther Square | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376539320 | Lutheran Home for The Aged | Skilled Nursing Facility | 2825 Bloomfield Rd, Cape Girardeau, MO 63703-6335 | 2005-09-26 |
| 1215061114 | Lutheran Home for The Aged | Assisted Living Facility | 2825 Bloomfield Rd, Cape Girardeau, MO 63703-6335 | 2007-03-15 |
| 1306970876 | Lutheran Home for The Aged | Assisted Living Facility | 2825 Bloomfield Rd, Cape Girardeau, MO 63703-6335 | 2007-03-15 |
| 1720195431 | Lutheran Home for The Aged | Hospice Care, Community Based | 2825 Bloomfield Rd, Cape Girardeau, MO 63703-6335 | 2006-08-25 |
| 1699700476 | Lutheran Home for The Aged | Home Health | 2825 Bloomfield Rd, Cape Girardeau, MO 63703-6335 | 2006-07-11 |
| 1619939196 | Lutheran Home for The Aged | Home Health | 2825 Bloomfield Rd, Cape Girardeau, MO 63703-6335 | 2006-04-03 |
| 1487641064 | Lutheran Home for The Aged | Skilled Nursing Facility | 800 W Oakton St, Arlington Heights, IL 60004-4602 | 2005-09-29 |
| Street Address |
149 W 22ND ST |
| City | ERIE |
| State | PA |
| Zip Code | 16502-2804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427699495 | Diane Boyd | Nurse Practitioner | 149 W 22nd St, Erie, PA 16502-2804 | 2019-10-01 |
| 1689231029 | Lecom At Village Square, LLC | Skilled Nursing Facility | 149 W 22nd St, Erie, PA 16502-2804 | 2019-05-21 |
| 1407234859 | Mary Whipple | Nurse Practitioner | 149 W 22nd St, Erie, PA 16502-2804 | 2015-05-18 |
| 1174901375 | The Lutheran Home for The Aged D/b/a The Village At Luther Square | Skilled Nursing Facility | 149 W 22nd St, Erie, PA 16502-2804 | 2015-05-08 |
| 1730352071 | Glenn Robert Wolfe | Occupational Therapy Assistant | 149 W 22nd St, Erie, PA 16502-2804 | 2008-04-08 |
| 1891980355 | Life-northwestern Pennsylvania | PACE Provider Organization | 149 W 22nd St, Erie, PA 16502-2804 | 2007-09-07 |
| 1508856824 | Kevin P Shaffer | Family Medicine | 149 W 22nd St, Erie, PA 16502-2804 | 2005-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679064794 | Fernando Torres | Specialist/Technologist | 549 1/2 W 7th St, Erie, PA 16502 | 2018-05-24 |
| 1548782907 | Michael Wayne Hankins Jr. | Podiatrist | 5515 Peach Street, Erie, PA 16502 | 2017-07-07 |
| 1730609041 | Michael Greg Palmer | Family Medicine | 311 West 24th Street 4th Floor, Erie, PA 16502 | 2017-06-27 |
| 1245658723 | Amy Adamus | Licensed Practical Nurse | 1647 Sassafras Street, Erie, PA 16502 | 2014-04-02 |
| 1295011088 | Margaret Gay Wardd | Licensed Practical Nurse | 1757 West 23 Street, Erie, PA 16502 | 2011-10-25 |
| 1659510782 | Kristen Kathleen Curry | Social Worker | 329 W. 10th St., Erie, PA 16502 | 2009-02-12 |
| 1699928416 | Kelly Cathleen Kelly-zazado | Social Worker | 301 W. 10th St., Lake Erie Counseling, Inc, Erie, PA 16502 | 2008-10-23 |
| 1922149350 | Wei-lung Sam Wu | Internal Medicine | Saint Vincent Professional Building, 311 West 24 Street, Suite 402, Erie, PA 16502 | 2007-02-09 |
| 1003970146 | Claire Donch | Psychologist | 301 West 10th Street, Erie, PA 16502 | 2006-12-21 |
| 1730703117 | Vincent Viet Ngo | Family Medicine | 311 West 24th Street, 4th Floor, Erie, PA 16502 | 2020-06-02 |
| Find all providers in zip 16502 | ||||
| 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 |
|---|---|---|---|---|
| 1699904433 | Erie Operating LLC | Skilled Nursing Facility | 4850 Zuck Rd, Erie, PA 16506 | 2009-07-14 |
| 1558434118 | Extendicare Homes, Inc. | Skilled Nursing Facility | 1267 S Hill Rd, Erie, PA 16509-4831 | 2006-11-15 |
| 1831201946 | 4114 Schaper Avenue Operating Company, LLC | Skilled Nursing Facility | 4114 Schaper Avenue, Erie, PA 16508 | 2006-08-31 |
| 1003923566 | Presbyterian Homes In The Presbytery of Lake Erie | Skilled Nursing Facility | 1225 School Rd, Erie, PA 16505-2691 | 2006-08-23 |
| 1770595415 | Presbyterian Homes In The Presbytery of Lake Erie | Skilled Nursing Facility | 6351 W Lake Rd, Erie, PA 16505-2676 | 2006-08-12 |
| 1538115654 | Twinbrook Medical Center-erie Pa LLC | Skilled Nursing Facility | 3805 Field St, Erie, PA 16511-2825 | 2006-05-26 |
| 1184675563 | Ggnsc Erie II Lp | Skilled Nursing Facility | 2686 Peach St, Erie, PA 16508-1851 | 2006-05-12 |
| 1891746178 | Ggnsc Erie Western Reserve Lp | Skilled Nursing Facility | 1521 W 54th St, Erie, PA 16509-2620 | 2006-05-12 |
| 1891786604 | The Ball Pavilion | Skilled Nursing Facility | 5416 E Lake Rd, Erie, PA 16511-1427 | 2005-11-01 |
| 1003804634 | Asbury Atlantic, Inc | Skilled Nursing Facility | 2301 Edinboro Rd, Erie, PA 16509-3409 | 2005-10-07 |
| Find all providers in ERIE | ||||
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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.