NPIMap

Organization Active NPI

Windermere Health Center by Harborview, LLC

Doing business as Harborview Health Center of Augusta

  • Skilled Nursing Facility
  • Augusta, GA
National Provider Identifier
1093459893
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WINDERMERE HEALTH CENTER BY HARBORVIEW, LLC
Doing business as
Harborview Health Center of Augusta
Practice address
3618 J Dewey Gray Cir
Augusta, GA 30909-1867
Phone
(706) 860-7572
NPI assigned
Apr 27, 2022
Last updated
Apr 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Authorized official

Name
Chaim S Leibowitz
Title
Executive Vice President
Phone
(917) 804-1661

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3618 J Dewey Gray Cir
Augusta, GA 30909-1867

Mailing address

3618 J Dewey Gray Cir
Augusta, GA 30909-1867
Phone (706) 860-7572

Other names 1

  • Harborview Health Center of Augusta Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220610002593 GA Part A Provider - Skilled Nursing Facility 1759769276 Practice locations: Augusta, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093459893. Details of each certification follow.

Skilled nursing facility certification: CCN 115291

Legal name
WINDERMERE HEALTH CENTER BY HARBORVIEW, LLC
Doing business as
HARBORVIEW HEALTH CENTER OF AUGUSTA
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 15, 1982
Last certification
Dec 10, 2023
Beds
120
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Harborview Health System
Organization structure
LLCProprietary
Incorporated
Dec 30, 2021 in DE
Enrollment address
3618 J Dewey Gray Cir
Augusta, GA 30909-1867
Nursing home name
HARBORVIEW HEALTH CENTER OF AUGUSTA
Affiliated entity
HARBORVIEW HEALTH SYSTEMS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Harborview Health Center of AugustaCCN 115291 · All quality measures
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Apr 15, 1982
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120113.1 residents per day on average
Chain
Harborview Health Systems22 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Ashlyn Broderick Individual W-2 Managing EmployeeFacility Administrator Apr 27, 2022
David Englander Individual Corporate OfficerChief Executive Officer Apr 27, 2022
CL 2022 Irrv TR Organization, Cedarhurst, NY 5% Or Greater Indirect Ownership Interest Apr 1, 2022 50%
De 2021 Irrv TR Organization, Lawrence, NY 5% Or Greater Indirect Ownership Interest Apr 27, 2022 50%
Chaim Sholom Leibowitz Individual Corporate OfficerExecutive Vice President Apr 27, 2022
Ga NC 14, LLC Organization, Cedarhurst, NY LLC 5% Or Greater Direct Ownership Interest Apr 27, 2022 100%

Facilities with the same owner 17

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

View all 17

Practitioners & affiliated clinicians

Practitioners 3

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 3

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": "1651017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1093459893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3618 J DEWEY GRAY CIR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091867",
            "telephone_number": "706-860-7572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3618 J DEWEY GRAY CIR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091867",
            "telephone_number": "706-860-7572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDERMERE HEALTH CENTER BY HARBORVIEW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-27",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A",
        "authorized_official_last_name": "LEIBOWITZ",
        "authorized_official_first_name": "CHAIM",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "917-804-1661"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harborview Health Center of Augusta",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.