NPIMap

Organization Active NPI

Embassy Newark, LLC

  • Skilled Nursing Facility
  • Newark, OH
National Provider Identifier
1013684927
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
EMBASSY NEWARK, LLC
Practice address
75 McMillen Dr
Newark, OH 43055-1808
Phone
(740) 344-0357
NPI assigned
Aug 27, 2021
Last updated
Aug 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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

Authorized official

Name
Nicholas Ciccone
Title
Chief Compliance Officer
Phone
(570) 885-5841

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

75 McMillen Dr
Newark, OH 43055-1808

Mailing address

25201 Chagrin Blvd Ste 190
Beachwood, OH 44122-5633
Phone (216) 378-2050

Other identifiers 1

IdentifierTypeStateIssuer
1706NOtherOHLICENSURE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210907002780 OH Part A Provider - Skilled Nursing Facility 1658777248 Practice locations: Newark, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013684927. Details of each certification follow.

Skilled nursing facility certification: CCN 365425

Legal name
EMBASSY NEWARK LLC
Doing business as
EMBASSY OF NEWARK
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 19, 1979
Last certification
Aug 28, 2024
Beds
145
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Garden Springs Healthcare
Most recent change of ownership
Mar 24, 2026
Organization structure
LLCProprietary
Incorporated
Jul 16, 2021 in OH
Enrollment address
75 McMillen Drive
Newark, OH 43055-1808

Care Compare: Nursing home

Medicare Care Compare
Listed as
Newark Nursing & RehabCCN 365425 · All quality measures
Overall star rating
2 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Oct 19, 1979
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
145122.0 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0327659Embassy of Newark75 McMillen Dr, Newark, OH 43055Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
GSR Dynasty LLC Organization, Beachwood, OH LLC 5% Or Greater Indirect Ownership Interest Sep 1, 2021 50%
Aaron B Handler Individual Corporate OfficerVice Presdient Sep 1, 2021
Other Sep 1, 2021 50%
George S. Repchick Individual Corporate OfficerPresident Sep 1, 2021 50%
W-2 Managing EmployeePresident Sep 1, 2021 50%
Other Sep 1, 2021 50%
Embassy Healthcare Holdings Inc Organization, Beachwood, OH Corporation 5% Or Greater Direct Ownership Interest Sep 1, 2021 100%

Facilities with the same owner 29

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 29

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630022400000",
    "number": "1013684927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25201 CHAGRIN BLVD STE 190",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225633",
            "telephone_number": "216-378-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MCMILLEN DR",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551808",
            "telephone_number": "740-344-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBASSY NEWARK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-27",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A",
        "authorized_official_last_name": "CICCONE",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "570-885-5841"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "1706N",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.