Active NPI
The William Breman Jewish Home, Inc.
- Skilled Nursing Facility
- Atlanta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- THE WILLIAM BREMAN JEWISH HOME, INC.
- Practice address
- 3150 Howell Mill Rd NW
Atlanta, GA 30327-2108 - Phone
- (404) 351-2324
- Fax
- (404) 351-6698
- NPI assigned
- Jun 4, 2006
- Last updated
- Sep 18, 2024
- 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
- Ms. Neelam Rahatekar
- Title
- Cfo-Coo
- Phone
- (404) 351-1934
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | GA | Primary |
Addresses
Primary practice location
3150 Howell Mill Rd NW
Atlanta, GA 30327-2108
Mailing address
3150 Howell Mill Rd NW
Atlanta, GA 30327-2108
Phone (404) 351-2324
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00040752A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030424000031 | GA | Part A Provider - Skilled Nursing Facility | 6507775350 | Practice locations: Atlanta, GA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1154369635. Details of each certification follow.
Skilled nursing facility certification: CCN 115022
- Legal name
- THE WILLIAM BREMAN JEWISH HOME, INC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 1967
- Last certification
- Dec 12, 2024
- Beds
- 96
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Incorporated
- Mar 30, 1949 in GA
- Enrollment address
- 3150 Howell Mill Rd NW
Atlanta, GA 30327-2199 - Nursing home name
- THE WILLIAM BREMAN JEWISH HOME
Care Compare: Nursing home
Medicare Care Compare- Listed as
- The William Breman Jewish Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Jan 1, 1967
- Medicare certification status
- Active
- Certified beds
- 96
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D0645886 | William Breman Jewish Home | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 2
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 |
|---|---|---|---|
| Jeffrey Gopen | Operational/Managerial Control | Feb 6, 2017 | 100% |
| Neelam Rahatekar | Operational/Managerial Control | Mar 15, 2006 | 100% |
Practitioners & affiliated clinicians
Practitioners 2
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
- Dallas, GA
- NPI 1407056302
-
- Family Medicine Physician
- Marietta, GA
- NPI 1568499390
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": "1149379200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1726617600000",
"number": "1154369635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3150 HOWELL MILL RD NW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303272108",
"telephone_number": "404-351-2324",
"fax_number": "404-351-6698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3150 HOWELL MILL RD NW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303272108",
"telephone_number": "404-351-2324",
"fax_number": "404-351-6698"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE WILLIAM BREMAN JEWISH HOME, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-04",
"last_updated": "2024-09-18",
"certification_date": "2024-09-18",
"status": "A",
"authorized_official_last_name": "RAHATEKAR",
"authorized_official_first_name": "NEELAM",
"authorized_official_title_or_position": "CFO-COO",
"authorized_official_telephone_number": "404-351-1934",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "GA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00040752A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
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- The Wellness Well, LLC.
- The Whole Picture Nutrition Services LLC
- The Winn Way Network and Institute
- The Women's Healing Collective LLC
- The Worth, Wisdom, and Wellness Center LLC
- Thekey of Georgia, LLC
- Eby Ison Thekkedath, DO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.