Odd Fellows Home of Connecticut

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

258C Issued in CT

Legal business name

ODD FELLOWS HOME OF CONNECTICUT

Doing business as

Fairview

Practice address

235 Lestertown Road
Groton, CT 06340

Phone

(860) 445-7478

NPI assigned

May 15, 2006

Last updated

Jul 21, 2016By 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

James A Rosenman

Title

Administrator

Phone

(860) 445-7478

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• FAIRVIEW Doing business as

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083665988. Details of each certification follow.

• CCN 075288 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 075288

Legal name

ODD FELLOWS HOME OF CONNECTICUT

Doing business as

FAIRVIEW

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Oct 1, 1979

Last certification

Jul 17, 2024

Beds

120

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Enrollment address

235 Lestertown Rd
Groton, CT 06340-2808

Nursing home name

FAIRVIEW

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Odd Fellows Home of Connecticut

  dba Fairview

  • Rehabilitation Clinic/Center
  • Groton, CT
  • NPI 1609393909

  O20111203000087

  Same enrollment

Listed as

FairviewCCN 075288 · All quality measures

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

1 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Oct 1, 1979

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

12090.7 residents per day on average

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 16

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

Owners & managing parties with NPI records 1

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

• Fred Yeo, MD

  • Internal Medicine Physician
  • Groton, CT
  • NPI 1881686616

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Odd Fellows Home of Connecticut

  dba Fairview

  • Rehabilitation Clinic/Center
  • Groton, CT
  • NPI 1609393909
  NPPES parent name

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469059200000",
    "number": "1083665988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 LESTERTOWN ROAD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "06340",
            "telephone_number": "860-445-7478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 LESTERTOWN ROAD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "06340",
            "telephone_number": "860-445-7478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODD FELLOWS HOME OF CONNECTICUT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2016-07-21",
        "status": "A",
        "authorized_official_last_name": "ROSENMAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "860-445-7478"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "258C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000002584",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAIRVIEW",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nourish Rd LLC
• Jane Kathryn Novak, PTA
• Christopher Nunez, IDC
• Michael Nutt, IDC
• Katherine Oblinsky, BCBA
• Odd Fellows Home of Connecticut (Fairview)
• Kaitlyn Odonnell, PHARM.D.
• Patricia Odonnell, RPH
• Oyewole G Ogunnaike
• Robert M Okane

• Skilled Nursing Facility in Groton, CT
• Providers in Groton, CT by specialty
• Skilled Nursing Facility in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; 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.