Active NPI
Twin Lakes
- Skilled Nursing Facility
- Cincinnati, OH
National Provider Identifier
1144377276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- TWIN LAKES
- Practice address
- 9840 Montgomery Rd
Cincinnati, OH 45242-6255 - Phone
- (513) 247-1300
- NPI assigned
- Jan 4, 2007
- Last updated
- Aug 22, 2020
- 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
- James Bowersox
- Title
- Chief Financial Officer
- Phone
- (513) 719-3531
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NU | Primary |
Addresses
Primary practice location
9840 Montgomery Rd
Cincinnati, OH 45242-6255
Mailing address
9840 Montgomery Rd
Cincinnati, OH 45242-6255
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2602295 | 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 |
|---|---|---|---|---|
| O20050523000626 | OH | Part A Provider - Skilled Nursing Facility | 4385686195 | Practice locations: Cincinnati, OH |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1144377276. Details of each certification follow.
Skilled nursing facility certification: CCN 366319
- Legal name
- TWIN LAKES
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 2006
- Last certification
- Jun 6, 2024
- Beds
- 43
- Ownership / control type
- Nonprofit Corporation
- Multi-facility organization
- LIFE ENRICHING COMMUNITY
- Organization structure
- Corporation
- Incorporated
- Feb 15, 2000 in OH
- Enrollment address
- 9840 Montgomery Rd
Cincinnati, OH 45242-6255 - Nursing home name
- TWIN LAKES
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Twin Lakes
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Jan 1, 2006
- Medicare certification status
- Active
- Certified beds
- 43
National Provider Directory
National Provider Directory- Tax ID family
- Twin Lakes
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Assisted Living Facility
- Cincinnati, OH
- NPI 1902368988
Ownership & related parties
All disclosed owners & managing parties 10
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 |
|---|---|---|---|
| Douglas Burgess | Corporate Director | Nov 29, 2023 | |
| Denise Brown | W-2 Managing Employee | Jan 1, 2024 | |
| Robyn Hildal | Corporate Officer | Nov 15, 2017 | |
| Corporate Director | Nov 16, 2016 | ||
| James Bowersox | Corporate Officer | Nov 20, 2013 | |
| Corporate Director | Jul 13, 2007 | ||
| W-2 Managing Employee | Apr 26, 2006 | ||
| Larry Brueshaber | Corporate Director | Nov 29, 2023 | |
| Joseph Edward Thorpe | Corporate Director | Nov 29, 2023 | |
| Saba Azher Ansari | Contracted Managing Employee | Jan 1, 2024 | |
| Kenneth McDonald | W-2 Managing Employee | Jan 1, 2024 | |
| Scott M McQuinn | Corporate Officer | Nov 20, 2013 | |
| Corporate Director | May 23, 2005 | ||
| W-2 Managing Employee | May 31, 1996 | ||
| Todd Anderson | Corporate Director | Nov 29, 2023 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Geriatric Medicine (Internal Medicine) Physician
- Mason, OH
- NPI 1972506855
Contracted Managing Employee
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.
-
- Assisted Living Facility
- Cincinnati, OH
- NPI 1902368988
Practitioners & affiliated clinicians
Affiliated clinicians 9
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": "1167868800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1144377276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9840 MONTGOMERY RD",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452426255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9840 MONTGOMERY RD",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452426255",
"telephone_number": "513-247-1300"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TWIN LAKES",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-04",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "BOWERSOX",
"authorized_official_first_name": "JAMES",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "513-719-3531"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2602295",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.