115 S PROVIDENCE ROAD OPERATIONS LLC
NPI 1417667130
Skilled Nursing Facility in Wallingford, PA

Q: What is 115 S Providence Road Operations LLC's NPI number?

The NPI number for 115 S Providence Road Operations LLC is 1417667130. It was assigned to this organization in the NPPES registry on December 5, 2022. The provider is doing business as Wallingford Borough Skilled Nursing And Rehabilitation Center.

Q: What is 115 S Providence Road Operations LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Active since December 05, 2022

1/5

Overall Rating

115 S PROVIDENCE RD, WALLINGFORD, PA 19086(610) 444-6350 Get Directions Write a Review

NPPES record last updated: June 23, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 23, 2025, Nov 22, 2024, Jan 6, 2023 and 1 more (4 updates tracked since 2022).

On this page

About 115 S Providence Road Operations Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

115 S PROVIDENCE ROAD OPERATIONS LLC (NPI 1417667130), doing business as Wallingford Borough Skilled Nursing And Rehabilitation Center, is a healthcare organization registered as a skilled nursing facility in Wallingford, Pennsylvania and active in the NPI registry since December 2022. The organization lists Michael T Berg, Secretary, as its authorized official.

NPPES Registry Identity

NPI1417667130

Entity TypeOrganization

Primary Taxonomy314000000X

Legal Business Name115 S PROVIDENCE ROAD OPERATIONS LLC

Location Address115 S PROVIDENCE RDWallingford, PA 19086-6333

Mailing Address101 E State StKennett Square, PA 19348-3109 · Fax (610) 612-5327

Phone(610) 444-6350

Organization SubpartYesParent: Genesis Pm Pa Operations Llc

Authorized OfficialMichael T BergSecretary · (505) 468-4742

Enumeration DateDecember 5, 2022

Last NPPES UpdateJune 23, 20254 updates tracked since enumeration

NPPES CertifiedJune 23, 2025

✔ NPI 1417667130 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities

Taxonomy Code314000000X

Definition

(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.

115 S PROVIDENCE RD, Wallingford, PA 19086

Open in Google Maps ↗

Other Names 1

Doing Business AsWallingford Borough Skilled Nursing And Rehabilitation Center

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Wallingford Skilled Nursing And Rehabilitation Cen (CMS certification number 395685), from CMS Care Compare.

Wallingford Skilled Nursing And Rehabilitation Cen

Nursing home · Wallingford, PA

1/5 CMS Overall Rating

OwnershipFor profit - Corporation

CMS Certification Number395685

Certified Beds193 beds161 residents per day on average

Medicare & Medicaid Participant SinceDecember 11, 1984

Resident & Family CouncilResident council

Automatic sprinkler system

CMS Star Ratings

Quality Measures

Based on a select set of clinical quality measures.

2/5

Long-Stay Quality

Quality of care delivered to long-term residents.

2/5

Short-Stay Quality

Quality of care delivered to short-term and rehabilitation residents.

2/5

Staffing

Based on nursing staff hours relative to resident needs.

2/5

Weighted Health Inspection Score

Lower scores are better; the score summarizes deficiencies found on recent inspections.

242.17

Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing

nurse aide 1.79 · LPN 0.89 · RN 0.45

3.13 hrs per resident per day

Weekend Nurse Staffing

2.84 hrs per resident per day

Physical Therapist Staffing

0.05 hrs per resident per day

Nursing Staff Turnover

Share of nursing staff who left the facility within the past year.

41.3%

Registered Nurse Turnover

42.9%

Administrators Who Have Left

In the past year.

Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

CMS has flagged this facility with its abuse flag, indicating a citation for abuse or neglect on a recent inspection report.

Facility-Reported Incidents

Substantiated Complaints

Fines

5 totaling $368,993.75

Medicare Payment Denials

Total Penalties

Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. HEATHER L. COLE MOTR/L

Occupational Therapist