Organization Active NPI

Athens LTC, Inc

Doing business as The Laurels of Athens

  • Skilled Nursing Facility
  • Athens, OH
National Provider Identifier
1033405170
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ATHENS LTC, INC
Doing business as
The Laurels of Athens
Practice address
70 Circle Drive
Athens, OH 45701
Phone
(614) 794-8800
NPI assigned
Jun 28, 2011
Last updated
Nov 16, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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

Authorized official

Name
Anis Khan
Title
Cfo
Phone
(614) 794-8800

Specialties & licenses 1

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

Addresses

Primary practice location

70 Circle Drive
Athens, OH 45701

Mailing address

70 Columbus Circle
Athens, OH 45701-1312

Other identifiers 2

IdentifierTypeStateIssuer
OH05025OtherOHNURSING HOME LICENSE
0050912MedicaidOH

Other names 1

  • The Laurels of Athens Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110720000389 OH Part A Provider - Skilled Nursing Facility 0840468740 Practice locations: Athens, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033405170. Details of each certification follow.

Skilled nursing facility certification: CCN 366396

Legal name
ATHENS LTC, INC
Doing business as
THE LAURELS OF ATHENS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 6, 2011
Last certification
Dec 16, 2024
Beds
111
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Ciena Healthcare Management, Inc.
Organization structure
CorporationProprietary
Incorporated
Aug 27, 2007 in OH
Enrollment address
70 Columbus Circle Dr
Athens, OH 45701
Nursing home name
LAURELS OF ATHENS, THE
Affiliated entity
CIENA HEALTHCARE/LAUREL HEALTH CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Laurels of Athens, theCCN 366396 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Dec 6, 2011
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
111102.8 residents per day on average
Chain
Ciena Healthcare/Laurel Health Care81 facilities in the chain
Penalties (3 years)
1Fines totaling $38,912

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
36D2026709Laurels of Athens, the70 Circle Drive, Athens, OH 45701Certificate of waiverJul 7, 2027

National Provider Directory

National Provider Directory

Locations

70 Cir Dr
Athens, OH 45701
Phone (614) 794-8800

70 Columbus Cir
Athens, OH 45701
Phone (740) 592-1000

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Stephanie Cleland Individual Operational/Managerial Control Oct 19, 2022
Adp of the SNF Oct 19, 2022
David Stobb Individual Corporate OfficerSecretary Feb 1, 2016 100%
Adp of the SNF Jun 1, 2016
Anis Khan Individual Corporate OfficerTreasurer Feb 1, 2016
Operational/Managerial Control Feb 1, 2016
Adp of the SNF Feb 1, 2016
Laurel Acquisition Holding Corporation Organization, Westerville, OH Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2016 100%
Mohammad a. Qazi Individual 5% Or Greater Indirect Ownership InterestPresident Feb 1, 2016 100%
Corporate OfficerPresident Feb 1, 2016 100%
Corporate DirectorPresident Feb 1, 2016 100%
Operational/Managerial Control Feb 1, 2016
Mohammad a Qazi Living Trust Dated 09/26/97 Organization, West Bloomfield, MI For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2016 100%
Laurel Health Care Company Organization, Westerville, OH Corporation, Management services company, For-profit, Chain home office Operational/Managerial Control Feb 1, 2016
Adp of the SNF May 27, 2025
Laurel Health Care Holdings, Inc. Organization, Westerville, OH Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Feb 1, 2016 100%
Organization, Glenview, IL LLC, For-profit Adp of the SNF Apr 1, 2025
Organization, Taylor, MI LLC, For-profit Adp of the SNF Apr 1, 2025
John Edward Lloyd Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025

Owners & managing parties with NPI records 1

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

Facilities with the same owner 67

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

View all 67

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.

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": "1309219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479254400000",
    "number": "1033405170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 COLUMBUS CIRCLE",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457011312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 CIRCLE DRIVE",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "45701",
            "telephone_number": "614-794-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENS LTC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-28",
        "last_updated": "2016-11-16",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "ANIS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "614-794-8800"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING HOME LICENSE",
            "identifier": "OH05025",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0050912",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Laurels of Athens",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Athens, OH

Sources for this page

Verify at the official NPI Registry.