Active NPI
Ohio Living Sarah Moore
- Skilled Nursing Facility
- Delaware, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- OHIO LIVING SARAH MOORE
- Practice address
- 26 N Union St
Delaware, OH 43015-1922 - Phone
- (740) 362-9641
- Fax
- (740) 362-7039
- NPI assigned
- Apr 17, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robert B Stillman
- Title
- Chief Financial Officer
- Phone
- (614) 888-7800
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
26 N Union St
Delaware, OH 43015-1922
Mailing address
9200 Worthington Rd Ste 300
Westerville, OH 43082-7240
Phone (614) 888-7800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2101808 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050317000674 | OH | Part A Provider - Skilled Nursing Facility | 9133174659 | Practice locations: Delaware, OH |
Skilled nursing facility certification: CCN 366310
- Legal name
- OHIO LIVING SARAH MOORE
- Doing business as
- OHIO HEALTH DELAY THE DISEASE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 1, 2005
- Last certification
- Apr 18, 2024
- Beds
- 47
- Ownership / control type
- Nonprofit Corporation
- Multi-facility organization
- Ohio Living
- Organization structure
- Corporation
- Incorporated
- Mar 7, 1997 in OH
- Enrollment address
- 26 N Union St
Delaware, OH 43015-1922 - Nursing home name
- OHIO LIVING SARAH MOORE
- Affiliated entity
- OHIO LIVING COMMUNITIES
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Ohio Living Sarah Moore
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Apr 1, 2005
- Medicare certification status
- Active
- Certified beds
- 47
- Chain
- Ohio Living Communities
National Provider Directory
National Provider Directory- Tax ID family
- Ohio Living Sarah Moore
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Assisted Living Facility
- Delaware, OH
- NPI 1558914549
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Ownership & related parties
All disclosed owners & managing parties 14
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Terry White | Corporate Director | Jul 1, 2019 | |
| Melissa Ingwersen | Corporate Director | Jul 1, 2022 | |
| Laurence C Gumina | Corporate Officer | Nov 1, 2016 | |
| Peter D Hucek | Operational/Managerial Control | May 1, 2019 | |
| Adp of the SNF | May 1, 2019 | ||
| Robert B Stillman | Corporate Officer | Nov 1, 2016 | |
| James Joyce | Corporate Director | Jul 1, 2010 | |
| Aric Arnett | Operational/Managerial Control | Sep 15, 2014 | |
| Adp of the SNF | Sep 15, 2014 | ||
| Adp of the SNF | Dec 2, 2024 | ||
| Adp of the SNF | Dec 2, 2024 | ||
| Adp of the SNF | Dec 2, 2024 | ||
| Leslie Belfance | Corporate Director | Jan 1, 2023 | |
| Adp of the SNF | Dec 2, 2024 | ||
| Sandra M. Adam | Corporate Director | Jul 1, 2019 | |
| Adp of the SNF | Dec 5, 2024 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Granville, OH
- NPI 1548274871
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- New Albany, OH
- NPI 1891831384
-
- Family Medicine Physician
- Granville, OH
- NPI 1548274871
Affiliated clinicians 2
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": "1145232000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1661472000000",
"number": "1063476802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9200 WORTHINGTON RD STE 300",
"city": "WESTERVILLE",
"state": "OH",
"postal_code": "430827240",
"telephone_number": "614-888-7800",
"fax_number": "614-888-6864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26 N UNION ST",
"city": "DELAWARE",
"state": "OH",
"postal_code": "430151922",
"telephone_number": "740-362-9641",
"fax_number": "740-362-7039"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OHIO LIVING SARAH MOORE",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-17",
"last_updated": "2022-08-26",
"certification_date": "2022-08-26",
"status": "A",
"authorized_official_last_name": "STILLMAN",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "614-888-7800"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2101808",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Delaware, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; 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.