Hudson Elms Opco, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

HUDSON ELMS OPCO, LLC

Practice address

563 W Streetsboro St
Hudson, OH 44236-2050

Phone

(330) 650-0436

NPI assigned

Jan 28, 2020

Last updated

Nov 16, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey Goldstein

Title

Managing Member

Phone

(718) 986-7317

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023649175. Details of each certification follow.

• CCN 365874 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 365874

Legal name

HUDSON ELMS OPCO LLC

Doing business as

HUDSON ELMS NURSING CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Apr 1, 1992

Last certification

Jun 22, 2023

Beds

50

Ownership / control type

Corporation

Most recent change of ownership

Feb 1, 2020

Organization structure

LLCProprietary

Incorporated

Nov 5, 2019 in OH

Enrollment address

563 West Streetsboro Road
Hudson, OH 44236-2050

Nursing home name

HUDSON ELMS NURSING CENTER

Affiliated entity

AOM HEALTHCARE

Listed as

Hudson Elms Nursing CenterCCN 365874 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

1 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Apr 1, 1992

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5042.7 residents per day on average

Chain

Aom Healthcare20 facilities in the chain

Penalties (3 years)

2Fines totaling $17,693

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Hudson Elms Opco LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Hudson Elms Opco, LLC

  • Assisted Living Facility
  • Hudson, OH
  • NPI 1356005037
  NPD tax ID

All disclosed owners & managing parties 3

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

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.

• John P Wagner, DO

  • Family Medicine Physician
  • Stow, OH
  • NPI 1104869080
  NPD (past)

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605484800000",
    "number": "1023649175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "563 W STREETSBORO ST",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442362050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "563 W STREETSBORO ST",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442362050",
            "telephone_number": "330-650-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUDSON ELMS OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-28",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "718-986-7317"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Hotz, ATC, LAT, NREMT
• Autumn Howard, RD
• Hudson Chiropractic, LLC
• Hudson City School District
• Hudson Elms
• Hudson Elms Opco, LLC
• Hudson Family Health Center, Inc.
• Hudson Family Practice, Inc
• Hudson Health and Rehabilitation Center, Inc. (Heritage of Hudson)
• Hudson Health Care, Inc. (Hudson Elms Nursing Home)

• Skilled Nursing Facility in Hudson, OH
• Providers in Hudson, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.