Organization Active NPI

Manorcare Health Services LLC

  • Skilled Nursing Facility
  • Dublin, OH
National Provider Identifier
1013332337
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
2658N Issued in OH
Legal business name
MANORCARE HEALTH SERVICES LLC
Practice address
4075 W Dublin Granville Rd
Dublin, OH 43017-1436
Phone
(614) 210-0541
Fax
(614) 210-0565
NPI assigned
Feb 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Authorized official

Name
Mr. Barry A Lazarus
Title
Vice President
Phone
(419) 252-5541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 2658N OH Primary

Addresses

Primary practice location

4075 W Dublin Granville Rd
Dublin, OH 43017-1436

Mailing address

333 N Summit St
Toledo, OH 43604-2615
Phone (419) 252-5541

Other identifiers 1

IdentifierTypeStateIssuer
01000666MedicaidOH

Other names 1

  • ProMedica Skilled Nursing and Rehabilitation (Dublin) Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1393200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644364800000",
    "number": "1013332337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042615",
            "telephone_number": "419-252-5541",
            "fax_number": "419-252-5548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4075 W DUBLIN GRANVILLE RD",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430171436",
            "telephone_number": "614-210-0541",
            "fax_number": "614-210-0565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANORCARE HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-24",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A",
        "authorized_official_last_name": "LAZARUS",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "419-252-5541",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "2658N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01000666",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N St 6th #900a",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ProMedica Skilled Nursing and Rehabilitation (Dublin)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ProMedica Skilled Nursing and Rehabilitation (Dublin)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dublin, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.