NPIMap

Organization Active NPI

Cincinnati Rehabilitation Hospital, LLC

Doing business as Cincinnati Rehabilitation Hospital

  • Rehabilitation Hospital
  • Blue Ash, OH
National Provider Identifier
1164147377
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
Legal business name
CINCINNATI REHABILITATION HOSPITAL, LLC
Doing business as
Cincinnati Rehabilitation Hospital
Practice address
4291 Parkview Dr
Blue Ash, OH 45242-5667
Phone
(513) 788-3313
NPI assigned
Oct 10, 2022
Last updated
Oct 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Authorized official

Name
Ms. Tracey Nixon
Title
Chief Compliance Officer
Phone
(469) 640-6503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X NU Primary

Addresses

Primary practice location

4291 Parkview Dr
Blue Ash, OH 45242-5667

Mailing address

450 Century Pkwy Ste 220
Allen, TX 75013-8135
Phone (469) 640-6503

Other names 1

  • Cincinnati Rehabilitation Hospital Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other CMS HIH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230912000710 OH Part A Provider - Hospital 7911361845 Practice locations: Blue Ash, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164147377. Details of each certification follow.

Hospital certification: CCN 363047

Legal name
CINCINNATI REHABILITATION HOSPITAL, LLC
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
Jan 8, 2024
Last certification
Jan 8, 2024
Beds
40
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Jan 20, 2021 in OH
Enrollment address
4291 Parkview Dr
Blue Ash, OH 45242-5667
Main/Primary Hospital Location
Hospital subgroups
Rehabilitation

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Cincinnati Rehabilitation Hospital LLCCCN 363047 · All quality measures
Ownership
For profit
Certified
Jan 8, 2024
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2286222Cincinnati Rehabilitation Hospital, LLC4291 Parkview Drive, Blue Ash, OH 45242Certificate of waiverJul 24, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Kennor Cross Opco Organization, Carrollton, TX LLC 5% Or Greater Indirect Ownership Interest Jul 10, 2023 25.29%
Tracey Nixon Individual 5% Or Greater Indirect Ownership Interest Jul 28, 2025 6.47%
Corporate OfficerChief Compliance Officer Jul 10, 2023
Shane Shoulders Individual 5% Or Greater Indirect Ownership Interest Jul 10, 2023 15.51%
Shires Equity Management, LLC Organization, Denison, TX LLC 5% Or Greater Indirect Ownership Interest Jul 28, 2025 6.32%
Mark Kevin Dwyer Individual W-2 Managing Employee Jul 28, 2025
5R Real Estate Investments, LLC Organization, Plano, TX LLC 5% Or Greater Indirect Ownership Interest Jul 28, 2025 6.32%
Nobis Rehabilitation Partners, LLC Organization, Lucas, TX LLC Operational/Managerial Control Jul 10, 2023
Nobis Hospital Investments, LLC Organization, Lucas, TX LLC 5% Or Greater Indirect Ownership Interest Jul 28, 2025 100%
Karen Macy Schepis Individual Corporate DirectorCorporate Director of Compliance Jul 10, 2023
Jerry Huggler Individual 5% Or Greater Indirect Ownership Interest Jul 28, 2025 6.87%
Deno Maggi Individual 5% Or Greater Indirect Ownership Interest Jul 10, 2023 6.32%
Mark Heath Individual 5% Or Greater Indirect Ownership Interest Jul 28, 2025 8.44%
Nobis Rehabilitation Holdings, LLC Organization, Lucas, TX LLC 5% Or Greater Indirect Ownership Interest Jul 28, 2025 100%
Margie Crawley Individual Corporate DirectorCorporate Director of Revenue Cycle Jul 10, 2023
NKD Rehab, LLC Organization, Grapevine, TX LLC 5% Or Greater Direct Ownership Interest Jul 10, 2023 100%
Shavelt Management Investors, LLC Organization, Dallas, TX LLC 5% Or Greater Indirect Ownership Interest Jul 28, 2025 9.19%

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 15

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

View all 15

Practitioners & affiliated clinicians

Practitioners 1

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 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": "1665360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1164147377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CENTURY PKWY STE 220",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750138135",
            "telephone_number": "469-640-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4291 PARKVIEW DR",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452425667",
            "telephone_number": "513-788-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CINCINNATI REHABILITATION HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-10",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "NIXON",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "469-640-6503",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "CMS HIH",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "7500 Security Blvd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212441849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Cincinnati Rehabilitation Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cincinnati Rehabilitation Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blue Ash, OH

Sources for this page

Verify at the official NPI Registry.