Maryville Nursing Home – Skilled Nursing Facility, NPI 1922095934

Maryville Nursing Home is a healthcare provider. based in Beaverton, Oregon. specializing in Skilled Nursing Facility. The organization holds a License No. 00817 (OR). The NPI Number for Maryville Nursing Home is 1922095934

Main info

Organization
Name
Maryville Nursing Home
NPI
1922095934
Phone
(503) 643-8626
Address
14645 SW FARMINGTON RD
Authorized Official
MRS. KATHLEEN A. PARRY ADMINISTRATOR
Enumeration Date
4 October 2005
Last Update Date
10 March 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness80
Years active:20State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Maryville Nursing Home

  • Southwest Farmington Road, Downtown Beaverton, Central Beaverton, Beaverton, Washington County, Oregon, 97005, United States

    BEAVERTON, OR 970072727

    Phone: (503) 643-8626

    Fax: (503) 520-1435

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-08-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20050801000634OSkilled Nursing FacilityORTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97007)

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Reviews

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Frequently asked questions

What is the standard ID for Maryville Nursing Home in the U.S.?
In the U.S., Maryville Nursing Home is identified by NPI 1922095934.
Does the public listing show Maryville Nursing Home as active?
Maryville Nursing Home's NPI record reflects an active status in NPPES.
What type of care does Maryville Nursing Home provide?
Maryville Nursing Home's profile centers on Skilled Nursing Facility. Clinical services aligned with this taxonomy classification.
Is Maryville Nursing Home tied to Beaverton, Oregon?
If you are local to Beaverton, Oregon, Maryville Nursing Home may be relevant to your search.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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