Active NPI
Delmar Gardens of Gwinnett Operating, LLC
Doing business as Delmar Gardens of Gwinnett
- Skilled Nursing Facility
- Lawrenceville, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 1-067-1829
- Legal business name
- DELMAR GARDENS OF GWINNETT OPERATING, LLC
- Doing business as
- Delmar Gardens of Gwinnett
- Practice address
- 3100 Club Dr
Lawrenceville, GA 30044-2591 - Phone
- (770) 923-3100
- Fax
- (770) 381-5422
- NPI assigned
- Sep 20, 2005
- Last updated
- Jan 12, 2016
- 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
- Mr. Gail Lee Hartmann
- Title
- Treasurer
- Phone
- (636) 733-7000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 1-067-1829 | GA | Primary |
Addresses
Primary practice location
3100 Club Dr
Lawrenceville, GA 30044-2591
Mailing address
14805 N Outer 40 Rd
Suite 300
Chesterfield, MO 63017-6060
Phone (636) 733-7000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 156912785A | Medicaid | GA |
Other names 1
- Delmar Gardens of Gwinnett
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050322000969 | GA | Part A Provider - Skilled Nursing Facility | 8820044951 | Practice locations: Lawrenceville, GA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1255327862. Details of each certification follow.
Skilled nursing facility certification: CCN 115350
- Legal name
- DELMAR GARDENS OF GWINNETT OPERATING LLC
- Doing business as
- DELMAR GARDENS OF GWINNETT
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Feb 2, 1989
- Last certification
- Apr 16, 2024
- Beds
- 67
- Ownership / control type
- Corporation
- Multi-facility organization
- Delmar Gardens Enterprises, Inc.
- Organization structure
- LLC
- Incorporated
- Mar 14, 2003 in GA
- Enrollment address
- 3100 Club Dr
Lawrenceville, GA 30044-2591 - Nursing home name
- DELMAR GARDENS OF GWINNETT
- Affiliated entity
- DELMAR GARDENS
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Delmar Gardens of Gwinnett
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Feb 2, 1989
- Medicare certification status
- Active
- Certified beds
- 67
- Chain
- Delmar Gardens
National Provider Directory
National Provider Directory- Tax ID family
- Delmar Gardens of Gwinnett
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Delmar Gardens of Gwinnett
- Assisted Living Facility
- Lawrenceville, GA
- NPI 1366841314
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Janice G Bitansky | Other | Nov 30, 2010 | 4.26% |
| Harry Z Goldberg | Other | Nov 30, 2010 | 4.26% |
| Non-Gstfamily Trust Est U/W Israel Goldberg Fbo Diane Fredman | 5% Or Greater Indirect Ownership Interest | Apr 10, 2013 | 5.71% |
| Kaline E Valleray | Operational/Managerial Control | Dec 5, 2022 | |
| Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara | 5% Or Greater Indirect Ownership Interest | Mar 14, 2003 | 8.04% |
| Delmar Gardens Management Services Inc | Operational/Managerial Control | Apr 1, 2005 | 100% |
| Delmar Gardens Enterprises Inc | 5% Or Greater Direct Ownership Interest | Mar 14, 2003 | 100% |
| Diane G Fredman | Other | Nov 30, 2010 | 4.26% |
| Gabe Grossberg | 5% Or Greater Indirect Ownership Interest | Mar 14, 2003 | 16.33% |
| Corporate Officer | Mar 14, 2003 | ||
| Other | Mar 14, 2003 | ||
| Goldberg-Nom LLC | 5% Or Greater Indirect Ownership Interest | Mar 14, 2003 | 25% |
| George T Grossberg | 5% Or Greater Indirect Ownership Interest | Mar 14, 2003 | 11.33% |
| Other | Mar 14, 2003 | ||
| Non-GST Family Trust Est U/W of Israel Goldberg Fbo Janice Bitanski | 5% Or Greater Indirect Ownership Interest | Apr 10, 2013 | 5.71% |
| Howard M Oppenheimer | Corporate Officer | Mar 14, 2003 | |
| Other | Mar 14, 2003 | ||
| Kenneth F Marx | Corporate Officer | Jun 11, 2019 | |
| George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara | 5% Or Greater Indirect Ownership Interest | Mar 14, 2003 | 8.04% |
| Non-GST Family Trust Established U/W of Israel Goldberg Fbo Harry Zvi | 5% Or Greater Indirect Ownership Interest | Apr 10, 2013 | 5.71% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Psychiatry Physician
- Saint Louis, MO
- NPI 1033135991
5% Or Greater Indirect Ownership Interest, Other
Facilities with the same owner 16
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Delmar Gardens of Smyrna
- Skilled Nursing Facility
- Smyrna, GA
- NPI 1194711606
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
-
dba Delmar Gardens Home Care
- Home Health Agency
- Chesterfield, MO
- NPI 1295720118
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
-
dba Delmar Gardens North
- Skilled Nursing Facility
- Black Jack, MO
- NPI 1750376612
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
-
dba Delmar Gardens of Chesterfield
- Skilled Nursing Facility
- Chesterfield, MO
- NPI 1861487712
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
-
dba Delmar Gardens of Creve Coeur
- Skilled Nursing Facility
- Creve Coeur, MO
- NPI 1265427124
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
-
dba Delmar Gardens of Lenexa
- Skilled Nursing Facility
- Lenexa, KS
- NPI 1336134295
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
-
dba Delmar Gardens of Meramec Valley
- Skilled Nursing Facility
- Fenton, MO
- NPI 1013903525
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
-
dba Delmar Gardens of O'Fallon
- Skilled Nursing Facility
- O'Fallon, MO
- NPI 1942295803
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
-
dba St. Joseph Villa
- Skilled Nursing Facility
- Omaha, NE
- NPI 1417942277
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
-
dba St. Joseph Villa Homecare & Hospice
- Home Health Agency
- Omaha, NE
- NPI 1760477525
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
-
dba St. Joseph Villa Homecare & Hospice
- Community Based Hospice Care Agency
- Omaha, NE
- NPI 1790771301
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
-
dba Delmar Gardens of Overland Park
- Skilled Nursing Facility
- Overland Park, KS
- NPI 1285629048
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
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.
-
- Primary Care Clinic/Center
- Braselton, GA
- NPI 1568727220
-
- Internal Medicine Physician
- Suwanee, GA
- NPI 1184836488
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": "1127174400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1452556800000",
"number": "1255327862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14805 N OUTER 40 RD",
"address_2": "SUITE 300",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630176060",
"telephone_number": "636-733-7000",
"fax_number": "636-733-7010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 CLUB DR",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300442591",
"telephone_number": "770-923-3100",
"fax_number": "770-381-5422"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DELMAR GARDENS OF GWINNETT OPERATING, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-20",
"last_updated": "2016-01-12",
"status": "A",
"authorized_official_last_name": "HARTMANN",
"authorized_official_first_name": "GAIL",
"authorized_official_middle_name": "LEE",
"authorized_official_title_or_position": "TREASURER",
"authorized_official_telephone_number": "636-733-7000",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "GA",
"license": "1-067-1829",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "156912785A",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Delmar Gardens of Gwinnett",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lawrenceville, GA
- Yeira Deleon-Solis, LAPC, NCC
- Rachel Delgado
- Ricardo J Delgado, MD
- Delightfull Home Health Care LLC (Delightful Home Care)
- Maggie Dellaperuta, M.ED,CCC-SLP
- Delmar Gardens of Gwinnett Operating, LLC (Delmar Gardens of Gwinnett)
- Weldon Delmer
- Llewellyn Rachel Delsarte
- Piper Keely Demaine, CCC-SLP
- Francesca Demilord
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2016; 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.