Active NPI
Beechwood Home
- Skilled Nursing Facility
- Cincinnati, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 510646896
- 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, 2012
- 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
- Mrs. Patricia Clark
- Title
- Ceo
- Phone
- (513) 321-9294
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0035527 | Medicaid | OH | |
| 000000295145 | Other | ANTHEM BC / BS |
Other names 1
- Beechwood Home for the Incurables
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Other
- 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 Incurables
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Mar 7, 1980
- Medicare certification status
- Active
- Certified beds
- 80
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D0662348 | Beechwood Home | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Donna Z Shambley-Ebron | Corporate Director | Jan 1, 2018 | |
| Trustee of the SNF | Jan 1, 2018 | ||
| Mary Lane | Corporate Director | Jan 1, 2016 | |
| Trustee of the SNF | Jan 1, 2016 | ||
| Sara K Osborn | Corporate Officer | Feb 21, 2019 | |
| Corporate Director | Jan 1, 2017 | ||
| Trustee of the SNF | Jan 1, 2017 | ||
| Joseph a Huschart | Adp of the SNF | May 12, 2025 | |
| James R Gibbs | Corporate Officer | Jan 1, 2016 | |
| Corporate Director | Jan 1, 2007 | ||
| Trustee of the SNF | Jan 1, 2007 | ||
| Robert L Reed | Corporate Director | Jan 1, 2025 | |
| Trustee of the SNF | Jan 1, 2025 | ||
| Martha C Walsh | Corporate Director | Jan 1, 2022 | |
| Trustee of the SNF | Jan 1, 2022 | ||
| Renie L Dohrmann | Corporate Director | Jan 1, 2020 | |
| Trustee of the SNF | Jan 1, 2020 | ||
| Cristal Vincent | Corporate Officer | Jul 17, 2024 | 50% |
| Operational/Managerial Control | Jul 17, 2024 | ||
| Adp of the SNF | May 12, 2025 | ||
| Robert Heidt | Corporate Officer | Jan 1, 2016 | |
| Corporate Director | Jan 1, 2016 | ||
| Trustee of the SNF | Jan 1, 2016 | ||
| Karen M Ewing | Corporate Officer | Feb 13, 2023 | |
| Tracy M Sandquist | Corporate Director | Jan 1, 2022 | |
| Trustee of the SNF | Jan 1, 2022 | ||
| Timothy H Owens | Corporate Director | Jan 1, 2025 | |
| Trustee of the SNF | Jan 1, 2025 | ||
| Jeffrey Keller | Corporate Director | Jan 1, 2016 | |
| Trustee of the SNF | Jan 1, 2016 | ||
| Samuel Bortz | Corporate Officer | Jan 1, 2025 | |
| Corporate Director | Jan 1, 2016 | ||
| Trustee of the SNF | Jan 1, 2022 | ||
| Monte V Stetler | Corporate Officer | Jul 11, 2024 | |
| Ellen R Seward | Corporate Director | Jan 1, 2017 | |
| Trustee of the SNF | Jan 1, 2017 | ||
| Timothy C Toft | Corporate Officer | Jan 1, 2025 | |
| Corporate Director | Jan 1, 2006 | ||
| Trustee of the SNF | Jan 1, 2006 | ||
| Patricia a Clark | Corporate Officer | 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.
-
- Neurology Physician
- Cincinnati, OH
- NPI 1982701405
Corporate Director, Trustee of the SNF
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.
-
- Internal Medicine Physician
- Cincinnati, OH
- NPI 1003818402
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
- Ronnell D Beech Sr.
- Eric Beecham, MD
- Susan Beecher, RN, CRNA
- Beechmont Chiropractic Center LLC (Beechmont Chiropractic)
- Beechmont Dental Dr. Patel, Inc.
- Beechwood Terrace Care Center, Inc. (Forest Hills Care Center)
- Molly Beeckman, RD, LD
- Abigail M Beekman
- Madison Brianne Beekman, DPT
- Elaine S Beeler, PCC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; 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.