NPIMap

Organization Active NPI

Majestic Care of Whitehall LLC

  • Skilled Nursing Facility
  • Whitehall, OH
National Provider Identifier
1023576303
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MAJESTIC CARE OF WHITEHALL LLC
Practice address
4805 Langley Ave
Whitehall, OH 43213-6125
Phone
(614) 501-8271
Fax
(614) 861-3033
NPI assigned
Mar 6, 2019
Last updated
Mar 6, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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

Authorized official

Name
Hayley B Williams
Title
Attorney
Phone
(216) 706-3936

Specialties & licenses 1

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

Addresses

Primary practice location

4805 Langley Ave
Whitehall, OH 43213-6125

Mailing address

158-13 72ND Avenue
Flushing, NY 11365
Phone (614) 501-8271

Other identifiers 1

IdentifierTypeStateIssuer
2288NOtherOHLICENSURE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190516003071 OH Part A Provider - Skilled Nursing Facility 5890038731 Practice locations: Whitehall, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023576303. Details of each certification follow.

Skilled nursing facility certification: CCN 366201

Legal name
MAJESTIC CARE OF WHITEHALL LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 22, 2000
Last certification
Jun 18, 2024
Beds
150
Ownership / control type
Individual
Organization structure
LLCProprietary
Incorporated
Jan 31, 2019 in OH
Enrollment address
4805 Langley Ave
Whitehall, OH 43213-6125
Nursing home name
MAJESTIC CARE OF WHITEHALL
Affiliated entity
MAJESTIC CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Majestic Care of WhitehallCCN 366201 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Aug 22, 2000
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
150127.4 residents per day on average
Chain
Majestic Care22 facilities in the chain
Penalties (3 years)
1Fines totaling $0

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
36D0974249Majestic Care of Whitehall LLC4805 Langley Avenue, Whitehall, OH 43213Certificate of waiverMay 31, 2028

National Provider Directory

National Provider Directory

Locations

4805 Langley Ave
Whitehall, OH 43213
Phone (614) 344-6825

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
David Alexander Individual Operational/Managerial Control May 1, 2023
Adp of the SNF May 1, 2023
4805 Langley SNF Realty LLC Organization, Fresh Meadows, NY LLC Adp of the SNF Mar 29, 2019
Majestic Management LLC Organization, Westfield, IN LLC, Management services company Operational/Managerial Control Mar 29, 2019
Adp of the SNF Apr 1, 2025
Angela Rewa Individual Operational/Managerial Control Oct 23, 2023
Adp of the SNF Oct 23, 2023
Robert Laron Russell Individual Operational/Managerial Control Apr 8, 2024
Adp of the SNF Apr 8, 2024
Rondel Boyd Individual Operational/Managerial Control Dec 2, 2024
Adp of the SNF Dec 2, 2024
Daniel Miller Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Paul Pruitt Individual Operational/Managerial Control May 1, 2023
Adp of the SNF May 1, 2023
MDG Real Estate Global Limited Organization, Fresh Meadows, NY LLC Adp of the SNF Mar 29, 2019
Margaret Chamberlain Individual Corporate OfficerGeneral Counsel Sep 11, 2023 10%
Anzhelika Shatrov Individual Operational/Managerial Control Dec 2, 2024
Adp of the SNF Dec 2, 2024
David Marx Individual 5% Or Greater Direct Ownership InterestOwner Jan 1, 2019 100%
Adp of the SNF Mar 29, 2019
Eric Wolfe Individual Operational/Managerial Control Sep 11, 2023
Adp of the SNF Sep 11, 2023

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 20

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

View all 20

Practitioners & affiliated clinicians

Practitioners 2

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.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551830400000",
    "number": "1023576303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158-13 72ND AVENUE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11365",
            "telephone_number": "614-501-8271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 LANGLEY AVE",
            "city": "WHITEHALL",
            "state": "OH",
            "postal_code": "432136125",
            "telephone_number": "614-501-8271",
            "fax_number": "614-861-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAJESTIC CARE OF WHITEHALL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-06",
        "last_updated": "2019-03-06",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "HAYLEY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "ATTORNEY",
        "authorized_official_telephone_number": "216-706-3936"
    },
    "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": "2288N",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitehall, OH

Sources for this page

Verify at the official NPI Registry.