Active NPI
Jefferson Medical Associates, LLC
Doing business as Jefferson Healthcare Center
- Skilled Nursing Facility
- Jefferson, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- JEFFERSON MEDICAL ASSOCIATES, LLC
- Doing business as
- Jefferson Healthcare Center
- Practice address
- 222 E Beech St
Jefferson, OH 44047-9490 - Phone
- (440) 576-0060
- Fax
- (440) 576-2112
- NPI assigned
- May 4, 2006
- Last updated
- Aug 3, 2023
- 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
- Daniel Parker
- Title
- President
- Phone
- (440) 793-2245
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NU | Primary |
Addresses
Primary practice location
222 E Beech St
Jefferson, OH 44047-9490
Mailing address
25000 Country Club Blvd Ste 255
North Olmsted, OH 44070-5337
Phone (440) 793-2245
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2235245 | Medicaid | OH |
Other names 1
- Jefferson Healthcare Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120326000408 | OH | Part A Provider - Skilled Nursing Facility | 8729998273 | Practice locations: Jefferson, OH |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1124076054. Details of each certification follow.
Skilled nursing facility certification: CCN 365638
- Legal name
- JEFFERSON MEDICAL ASSOCIATES, LLC
- Doing business as
- JEFFERSON HEALTHCARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 25, 1984
- Last certification
- Nov 18, 2024
- Beds
- 90
- Ownership / control type
- Corporation
- Organization structure
- LLC
- Incorporated
- Apr 22, 1998 in OH
- Enrollment address
- 222 E Beech St
Jefferson, OH 44047-9490 - Nursing home name
- JEFFERSON HEALTHCARE CENTER
- Affiliated entity
- FOUNDATIONS HEALTH SOLUTIONS
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Jefferson Healthcare Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Oct 25, 1984
- Medicare certification status
- Active
- Certified beds
- 90
- Chain
- Foundations Health Solutions
National Provider Directory
National Provider Directory- Tax ID family
- Jefferson Health Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Skilled Nursing Facility
- Jefferson, OH
- NPI 1801881420
Ownership & related parties
All disclosed owners & managing parties 7
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 |
|---|---|---|---|
| Tishia Pratt | Operational/Managerial Control | Dec 12, 2011 | |
| Adp of the SNF | Dec 12, 2011 | ||
| John Krystowski | Corporate Officer | Jun 1, 2018 | |
| Operational/Managerial Control | Jun 1, 2018 | ||
| Adp of the SNF | Jun 1, 2018 | ||
| Brian E Colleran | Corporate Officer | Jan 1, 2019 | |
| Corporate Director | Jan 1, 2019 | ||
| Operational/Managerial Control | Jan 1, 2019 | ||
| Adp of the SNF | Jan 1, 2019 | ||
| Colleran Fam TR Dated 01-01-2018 | 5% Or Greater Indirect Ownership Interest | Jun 1, 2018 | 100% |
| Foundations Health LLC | 5% Or Greater Direct Ownership Interest | Jun 1, 2018 | 100% |
| Catherine a Bishop | Adp of the SNF | Jun 1, 2018 | |
| Foundations Health Solutions, LLC | Operational/Managerial Control | Jan 1, 2019 | |
| Adp of the SNF | May 7, 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 64
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Hickory Creek Nursing Center
- Skilled Nursing Facility
- The Plains, OH
- NPI 1831114446
Colleran Fam TR Dated 01-01-2018, Foundations Health LLC, Foundations Health Solutions, LLC
-
dba Siena Gardens Rehabilitation & Transitional Care
- Skilled Nursing Facility
- Cincinnati, OH
- NPI 1144713041
Colleran Fam TR Dated 01-01-2018, Foundations Health LLC, Foundations Health Solutions, LLC
-
dba The Woods On French Creek Nursing & Rehabilitation Center
- Skilled Nursing Facility
- Avon, OH
- NPI 1619373024
Colleran Fam TR Dated 01-01-2018, Foundations Health LLC, Foundations Health Solutions, LLC
-
dba Emerald Pointe Health and Rehabilitation Center
- Skilled Nursing Facility
- Barnesville, OH
- NPI 1174727192
Colleran Fam TR Dated 01-01-2018, Foundations Health LLC, Foundations Health Solutions, LLC
-
dba Champion Creek Health and Rehabilitation
- Skilled Nursing Facility
- Medina, OH
- NPI 1205636081
Colleran Fam TR Dated 01-01-2018, Foundations Health LLC, Foundations Health Solutions, LLC
-
dba Brunswick Pointe Transitional Care
- Skilled Nursing Facility
- Brunswick, OH
- NPI 1548780802
Colleran Fam TR Dated 01-01-2018, Foundations Health LLC, Foundations Health Solutions, LLC
-
dba Canterbury Villa of Alliance
- Skilled Nursing Facility
- Alliance, OH
- NPI 1790787968
Colleran Fam TR Dated 01-01-2018, Foundations Health LLC, Foundations Health Solutions, LLC
-
dba Capri Gardens
- Skilled Nursing Facility
- Lewis Center, OH
- NPI 1972164713
Colleran Fam TR Dated 01-01-2018, Foundations Health LLC, Foundations Health Solutions, LLC
-
dba Scenic Pointe Nursing & Rehabilitation
- Skilled Nursing Facility
- Millersburg, OH
- NPI 1124068994
Colleran Fam TR Dated 01-01-2018, Foundations Health LLC, Foundations Health Solutions, LLC
-
dba Sycamore Run Nursing & Rehabilitation
- Skilled Nursing Facility
- Millersburg, OH
- NPI 1891739843
Colleran Fam TR Dated 01-01-2018, Foundations Health LLC, Foundations Health Solutions, LLC
-
dba Arlington Care Center
- Skilled Nursing Facility
- Newark, OH
- NPI 1306820691
Colleran Fam TR Dated 01-01-2018, Foundations Health LLC
-
dba Veranda Gardens
- Skilled Nursing Facility
- Cincinnati, OH
- NPI 1043330533
Colleran Fam TR Dated 01-01-2018, Foundations Health LLC, Foundations Health Solutions, LLC
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.
-
- Internal Medicine Physician
- Westlake, OH
- NPI 1639159528
-
- Family Medicine Physician
- Chillicothe, OH
- NPI 1932123296
-
- Family Medicine Physician
- Conneaut, OH
- NPI 1104836881
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": "1146700800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1691020800000",
"number": "1124076054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25000 COUNTRY CLUB BLVD STE 255",
"city": "NORTH OLMSTED",
"state": "OH",
"postal_code": "440705337",
"telephone_number": "440-793-2245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 E BEECH ST",
"city": "JEFFERSON",
"state": "OH",
"postal_code": "440479490",
"telephone_number": "440-576-0060",
"fax_number": "440-576-2112"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JEFFERSON MEDICAL ASSOCIATES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-04",
"last_updated": "2023-08-03",
"certification_date": "2023-08-03",
"status": "A",
"authorized_official_last_name": "PARKER",
"authorized_official_first_name": "DANIEL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "440-793-2245"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2235245",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Jefferson Healthcare Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Jefferson Healthcare Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Jefferson, OH
- Shannon Leigh Hudson, LPN
- Marsha Ann Hunter, R.N.
- Jefferson Area Local School District
- Jefferson Emergency Rescue District
- Jefferson Health Center
- Jefferson Rehabilitation and Wellness LLC (Integrative Physical Therapy Concepts, LLC)
- Darcy Jo Johnson
- Tracie King
- Pamela L. Lancaster, D.O.
- Loretta L Lingo
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.