NPIMap

Organization Active NPI

Lakewood Senior Campus, LLC

  • Skilled Nursing Facility
  • Lakewood, OH
National Provider Identifier
1114935392
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
4204 Issued in OH
Legal business name
LAKEWOOD SENIOR CAMPUS, LLC
Practice address
13900 Detroit Ave
Lakewood, OH 44107-4624
Phone
(440) 228-7650
Fax
(440) 228-7655
NPI assigned
Aug 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Authorized official

Name
Mr. John T. O'Neill, LNHA
Title
President
Phone
(440) 327-0110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 4204 OH Primary

Addresses

Primary practice location

13900 Detroit Ave
Lakewood, OH 44107-4624

Mailing address

34100 Center Ridge Rd
Suite 10
North Ridgeville, OH 44039-5311
Phone (440) 327-9777

Other identifiers 1

IdentifierTypeStateIssuer
4204OtherOHSTATE OF OHIO NURSING HOM

Other names 1

  • Lakewood Senior Health Campus Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061024000492 OH Part A Provider - Skilled Nursing Facility 9739186354 Practice locations: Lakewood, OH

Skilled nursing facility certification: CCN 365267

Legal name
LAKEWOOD SENIOR CAMPUS, LLC
Doing business as
O'NEILL HEALTHCARE - LAKEWOOD
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 6, 1971
Last certification
Aug 31, 2023
Beds
114
Ownership / control type
Individual
Organization structure
LLCProprietary
Enrollment address
13900 Detroit Ave
Lakewood, OH 44107-4624
Nursing home name
O'NEILL HEALTHCARE LAKEWOOD
Affiliated entity
O'NEILL HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
O'Neill Healthcare LakewoodCCN 365267
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Individual
Certified
Aug 6, 1971
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11490.2 residents per day on average
Chain
O'Neill Healthcare6 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Lakewood Senior Health Campus3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

34100 Center Ridge Rd
Ste 10
North Ridgeville, OH 44039

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
O'Neill Management, LLC Organization, North Ridgeville, OH For-profit Operational/Managerial Control Aug 1, 2006
Kimberly Chuma Individual Contracted Managing EmployeeAdministrator May 3, 2017
John Oneill Individual 5% Or Greater Indirect Ownership InterestPresident Jan 1, 2012 29.89%
Corporate OfficerPresident/Secretary Jan 2, 2012 100%
Doreen Ziska Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2012 19.18%
Deborah Oneill Individual 5% Or Greater Indirect Ownership InterestVice President Jan 1, 2017 11.05%
Corporate OfficerVice President/Treasurer Jan 1, 2012
Carlow LLC Organization, North Ridgeville, OH LLC 5% Or Greater Direct Ownership Interest Jan 1, 2012 100%

Facilities with the same owner 6

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

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.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1114935392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34100 CENTER RIDGE RD",
            "address_2": "SUITE 10",
            "city": "NORTH RIDGEVILLE",
            "state": "OH",
            "postal_code": "440395311",
            "telephone_number": "440-327-9777",
            "fax_number": "440-327-6172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13900 DETROIT AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441074624",
            "telephone_number": "440-228-7650",
            "fax_number": "440-228-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD SENIOR CAMPUS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "O'NEILL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-327-0110",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "4204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF OHIO NURSING HOM",
            "identifier": "4204",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakewood Senior Health Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakewood, OH

Sources for this page

Verify at the official NPI Registry.