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Organization Active NPI

Majestic Care of Cedar Village LLC

  • Skilled Nursing Facility
  • Mason, OH
National Provider Identifier
1235889593
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MAJESTIC CARE OF CEDAR VILLAGE LLC
Practice address
5467 Cedar Village Dr
Mason, OH 45040-8693
Phone
(513) 754-3100
Fax
(513) 336-3174
NPI assigned
Mar 28, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Authorized official

Name
Paul Pruitt III
Title
Ceo
Phone
(317) 288-4029

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

5467 Cedar Village Dr
Mason, OH 45040-8693

Mailing address

5467 Cedar Village Dr
Mason, OH 45040-8693
Phone (513) 754-3100

Other identifiers 1

IdentifierTypeStateIssuer
2109NOtherOHLICENSURE

Other names 1

  • Majestic Care of Cedar Village Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220609001898 OH Part A Provider - Skilled Nursing Facility 1456739093 Practice locations: Mason, OH

Skilled nursing facility certification: CCN 366120

Legal name
MAJESTIC CARE OF CEDAR VILLAGE LLC
Doing business as
MAJESTIC CARE OF CEDAR VILLAGE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 1, 1997
Last certification
Apr 3, 2024
Beds
162
Ownership / control type
Limited Liability Corporation
Multi-facility organization
MAJESTIC CARE
Most recent change of ownership
Apr 11, 2022
Organization structure
LLCProprietary
Incorporated
Feb 3, 2022 in OH
Enrollment address
5467 Cedar Village Dr
Mason, OH 45040-8693
Nursing home name
MAJESTIC CARE OF CEDAR VILLAGE.
Affiliated entity
MAJESTIC CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Majestic Care of Cedar Village.CCN 366120
Overall star rating
2 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Apr 1, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
162153.0 residents per day on average
Chain
Majestic Care22 facilities in the chain
Penalties (3 years)
2Fines totaling $62,205

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Individual Adp of the SNF Jan 1, 2025
Majestic Management LLC Organization, Westfield, IN LLC, Management services company, For-profit Operational/Managerial Control Apr 1, 2022
Adp of the SNF Jul 10, 2025
Andrew Loufman Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Majestic Care of Cedar Village Holdings LLC Organization, Flushing, NY LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Apr 11, 2022 100%
Angela Rewa Individual Operational/Managerial Control Oct 23, 2023
Adp of the SNF Oct 23, 2023
Robert Laron Russell Individual Operational/Managerial Control Apr 8, 2024
Adp of the SNF Apr 8, 2024
Paul Pruitt Individual Operational/Managerial Control May 1, 2023
Managing Control - Governing BodyCeo May 1, 2023
Adp of the SNF May 1, 2023
MDG Real Estate Global Limited Organization, Flushing, NY Holding company Adp of the SNF Apr 1, 2022
Cedar Village Health Property LLC Organization, Flushing, NY LLC Operational/Managerial Control Apr 1, 2022
Adp of the SNF Apr 1, 2022
Margaret Chamberlain Individual Operational/Managerial Control Sep 11, 2023
Adp of the SNF Sep 11, 2023
Anzhelika Shatrov Individual Operational/Managerial Control Dec 2, 2024
Adp of the SNF Dec 2, 2024
David Marx Individual 5% Or Greater Indirect Ownership InterestOwner Apr 11, 2022 100%
Operational/Managerial Control Apr 1, 2022
Adp of the SNF Apr 1, 2022
Cedar Village Health Property Holdings LLC Organization, Flushing, NY LLC, Holding company, For-profit Adp of the SNF Apr 1, 2022
Eric Wolfe Individual Operational/Managerial Control Sep 11, 2023
Adp of the SNF Sep 11, 2023

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 20

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

View all 20

Practitioners & affiliated clinicians

Practitioners 5

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

Affiliated clinicians 3

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": "1648425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689811200000",
    "number": "1235889593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5467 CEDAR VILLAGE DR",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450408693",
            "telephone_number": "513-754-3100",
            "fax_number": "513-336-3174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5467 CEDAR VILLAGE DR",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450408693",
            "telephone_number": "513-754-3100",
            "fax_number": "513-336-3174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAJESTIC CARE OF CEDAR VILLAGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-28",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-288-4029",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "2109N",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Majestic Care of Cedar Village",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Majestic Care of Cedar Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mason, OH

Sources for this page

Verify at the official NPI Registry.