Organization Active NPI

Beechwood Home

  • Skilled Nursing Facility
  • Cincinnati, OH
National Provider Identifier
1306849245
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
510646896 Issued in OH
Legal business name
BEECHWOOD HOME
Practice address
2140 Pogue Ave
Cincinnati, OH 45208-3234
Phone
(513) 321-9294
Fax
(513) 321-4664
NPI assigned
May 24, 2005
Last updated
Jan 13, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2012

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

Authorized official

Name
Mrs. Patricia Clark
Title
Ceo
Phone
(513) 321-9294

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 510646896 OH Primary

Addresses

Primary practice location

2140 Pogue Ave
Cincinnati, OH 45208-3234

Mailing address

2140 Pogue Ave
Cincinnati, OH 45208-3234
Phone (513) 321-9294

Other identifiers 2

IdentifierTypeStateIssuer
0035527MedicaidOH
000000295145OtherANTHEM BC / BS

Other names 1

  • Beechwood Home for the Incurables Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120306001017 OH Part A Provider - Skilled Nursing Facility 9335308675 Practice locations: Cincinnati, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306849245. Details of each certification follow.

Skilled nursing facility certification: CCN 365445

Legal name
BEECHWOOD HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 7, 1980
Last certification
May 22, 2025
Beds
80
Ownership / control type
Nonprofit Corporation
Organization structure
OtherNon-profit
Enrollment address
2140 Pogue Avenue
Cincinnati, OH 45208-3234
Nursing home name
BEECHWOOD HOME FOR INCURABLES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Beechwood Home for IncurablesCCN 365445 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Mar 7, 1980
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8071.4 residents per day on average

Processed by Care Compare on Aug 1, 2026.

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
36D0662348Beechwood Home2140 Pogue Avenue, Cincinnati, OH 45208Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Donna Z Shambley-Ebron Individual Corporate DirectorBoard of Trustees Jan 1, 2018
Trustee of the SNF Jan 1, 2018
Mary Lane Individual Corporate DirectorBoard MBR Jan 1, 2016
Trustee of the SNF Jan 1, 2016
Sara K Osborn Individual Corporate OfficerElected As Secretary Feb 21, 2019
Corporate DirectorElected As Board of Trustees Jan 1, 2017
Trustee of the SNF Jan 1, 2017
Joseph a Huschart Individual Adp of the SNF May 12, 2025
James R Gibbs Individual Corporate OfficerBoard Sec Jan 1, 2016
Corporate DirectorBoard MBR Jan 1, 2007
Trustee of the SNF Jan 1, 2007
Robert L Reed Individual Corporate DirectorBoard Member Jan 1, 2025
Trustee of the SNF Jan 1, 2025
Martha C Walsh Individual Corporate DirectorBoard of Trustees Jan 1, 2022
Trustee of the SNF Jan 1, 2022
Renie L Dohrmann Individual Corporate DirectorElected Board of Trustees Jan 1, 2020
Trustee of the SNF Jan 1, 2020
Cristal Vincent Individual Corporate OfficerAdministrator Jul 17, 2024 50%
Operational/Managerial Control Jul 17, 2024
Adp of the SNF May 12, 2025
Robert Heidt Individual Corporate OfficerElected Board of Trustee Jan 1, 2016
Corporate DirectorBoard MBR Jan 1, 2016
Trustee of the SNF Jan 1, 2016
Karen M Ewing Individual Corporate OfficerManager Financial Services Feb 13, 2023
Tracy M Sandquist Individual Corporate DirectorElected Board of Trustees Jan 1, 2022
Trustee of the SNF Jan 1, 2022
Timothy H Owens Individual Corporate DirectorBoard Trustee Jan 1, 2025
Trustee of the SNF Jan 1, 2025
Jeffrey Keller Individual Corporate DirectorBoard MBR Jan 1, 2016
Trustee of the SNF Jan 1, 2016
Samuel Bortz Individual Corporate OfficerElected As President Jan 1, 2025
Corporate DirectorBoard MBR Jan 1, 2016
Trustee of the SNF Jan 1, 2022
Monte V Stetler Individual Corporate OfficerCfo Jul 11, 2024
Ellen R Seward Individual Corporate DirectorElected Board of Trustees Jan 1, 2017
Trustee of the SNF Jan 1, 2017
Timothy C Toft Individual Corporate OfficerElected As Vice President Jan 1, 2025
Corporate DirectorBoard MBR Jan 1, 2006
Trustee of the SNF Jan 1, 2006
Patricia a Clark Individual Corporate OfficerCeo Aug 2, 2004

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

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": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326412800000",
    "number": "1306849245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 POGUE AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452083234",
            "telephone_number": "513-321-9294",
            "fax_number": "513-321-4664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 POGUE AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452083234",
            "telephone_number": "513-321-9294",
            "fax_number": "513-321-4664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEECHWOOD HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2012-01-13",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "513-321-9294",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "510646896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0035527",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC / BS",
            "identifier": "000000295145",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beechwood Home for the Incurables",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.