Shawneespring Health Care Center, LLC
Organization Active NPI Skilled Nursing Facility · Harrison, OH
NPI 1346219987 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1346219987
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 2438N (OH)
- Legal business name
- SHAWNEESPRING HEALTH CARE CENTER, LLC
- Practice address
- 10111 Simonson Rd
Harrison, OH 45030-2003 - Phone
- (513) 367-7780
- Fax
- (513) 367-7781
- NPI assigned
- Mar 16, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Barry N. Bortz, LNHA
- Title
- Ceo
- Phone
- (513) 943-4000
Owners & managing parties with NPI records 1
Facilities with the same owner 15
Practitioners 2
-
Mohammad A Tulimat, M. D.
Affiliated clinicians 1
Medicare Care Compare: Nursing home
- Listed as
- Shawneespring Health Care Center
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jan 25, 2006
- Medicare certification status
- Active
- Certified beds
- 140 · 123.4 residents per day on average
- Chain
- Carespring
- Penalties (3 years)
- 1 · fines totaling $28,190
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Skilled nursing facility certification: CCN 366320
- Legal name
- SHAWNEESPRING HEALTH CARE CENTER, LLC
- Doing business as
- SHAWNEESPRING OF HARRISON
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 25, 2006
- Last certification
- Jan 30, 2023
- Beds
- 140
- Ownership / control type
- Corporation
- Multi-facility organization
- Carespring Healthcare Management
- Organization structure
- LLC · Proprietary
- Incorporated
- Oct 18, 2002 in OH
- Enrollment address
- 10111 Simonson Rd
Harrison, OH 45030-2003 - Nursing home name
- SHAWNEESPRING HEALTH CARE CENTER
- Affiliated entity
- CARESPRING
All disclosed owners & managing parties 8
| Name | Role | Since | Share |
|---|---|---|---|
| Emmanuel V Rivera |
Contracted Managing Employee |
Jan 1, 2024 | |
| Leah Marcum |
W-2 Managing Employee |
Jun 12, 2023 | 100% |
| Barry N Bortz Trust/Donald Mendelsohn Trustee |
5% Or Greater Indirect Ownership Interest | Oct 1, 2013 | 72% |
| Christopher Chirumbolo |
Corporate Officer |
Sep 1, 2016 | 100% |
| Carespring Health Care Management, LLC |
Operational/Managerial Control | Feb 28, 2007 | |
| Carespring Health Care Holdings LP |
5% Or Greater Direct Ownership Interest | Oct 1, 2013 | 100% |
| Bortz Family Trust/Key Bank Trustee |
5% Or Greater Indirect Ownership Interest | Oct 1, 2013 | 9% |
| David Eppers |
5% Or Greater Indirect Ownership Interest | Oct 1, 2013 | 15% |
| Corporate Officer |
Oct 1, 2013 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050923000091 | OH | Part a Provider - Skilled Nursing Facility | 3971537408 | Practice locations: Harrison, OH |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 2438N | OH | Yes |
Addresses
Primary practice location
10111 Simonson Rd
Harrison, OH 45030-2003
Mailing address
390 Wards Corner Rd
Loveland, OH 45140-6969
Phone (513) 943-4000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2618635 | Medicaid | OH |
Other providers in Harrison, OH
- Kennedy Marie Schuh
- John Schulte
- Jennifer Lynn Schultheis
- Amy Renee Schwartz
- Elizabeth Schweinberg
- Dixie Elaine Shumway
- Julie Siemer
- Kelsey Marie Sierra
- Logan Sillies
- Shelly E Smith
All providers in Harrison, OH · Skilled Nursing Facility in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.