NPIMap

Organization Active NPI

Life Care Center of Medina

  • Skilled Nursing Facility
  • Medina, OH
National Provider Identifier
1255548392
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
007861 Issued in OH
Legal business name
LIFE CARE CENTER OF MEDINA
Practice address
2400 Columbia Rd
Medina, OH 44256-9414
Phone
(330) 483-3131
Fax
(330) 483-3132
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Shelley A. EberhardtNPI 1508058488
Title
Director of Rehab
Phone
(330) 483-3131

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 007861 OH Primary

Addresses

Primary practice location

2400 Columbia Rd
Medina, OH 44256-9414

Mailing address

5839 Sleepy Hollow Rd
Valley City, OH 44280-9738
Phone (330) 483-3305

National Provider Directory

National Provider Directory
Tax ID family
Medina Operations LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255548392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5839 SLEEPY HOLLOW RD",
            "city": "VALLEY CITY",
            "state": "OH",
            "postal_code": "442809738",
            "telephone_number": "330-483-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 COLUMBIA RD",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442569414",
            "telephone_number": "330-483-3131",
            "fax_number": "330-483-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CARE CENTER OF MEDINA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EBERHARDT",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "DIRECTOR OF REHAB",
        "authorized_official_telephone_number": "330-483-3131"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "007861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.