Active NPI
Paul'S Run
- Assisted Living Facility
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- 176990
- Legal business name
- PAUL'S RUN
- Practice address
- 9896 Bustleton Ave
Philadelphia, PA 19115-5202 - Phone
- (215) 934-3000
- Fax
- (215) 934-3018
- NPI assigned
- Aug 4, 2005
- 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. John M. Barnum
- Title
- VP/Cfo
- Phone
- (215) 643-6333
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 176990 | PA | Primary |
| Skilled Nursing Facility | 314000000X | 161902 | PA |
Addresses
Primary practice location
9896 Bustleton Ave
Philadelphia, PA 19115-5202
Mailing address
250 N Bethlehem Pike
Ambler, PA 19002-3524
Phone (215) 643-6333
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0908820001 | Other | DMERC SUPPLIER # | |
| 0012939630002 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070917000266 | PA | Part A Provider - Skilled Nursing Facility | 1951495373 | Practice locations: Philadelphia, PA |
Skilled nursing facility certification: CCN 395738
- Legal name
- PAUL'S RUN
- Doing business as
- CLIPBOARD HEALTH
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Aug 10, 1987
- Last certification
- Oct 18, 2024
- Beds
- 119
- Ownership / control type
- Nonprofit Corporation
- Multi-facility organization
- Liberty Lutheran
- Organization structure
- Other
- Incorporated
- Nov 3, 1977 in PA
- Enrollment address
- 9896 Bustleton Ave
Philadelphia, PA 19115-5202 - Nursing home name
- PAUL'S RUN
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Paul'S Run
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Aug 10, 1987
- Medicare certification status
- Active
- Certified beds
- 119
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 |
|---|---|---|---|
| 39D0898920 | Paul'S Run | Certificate of waiver | Mar 15, 2027 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 26
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 |
|---|---|---|---|
| Akulkumar Patel | Adp of the SNF | Feb 15, 2024 | |
| Annabelle Fernandez-Miller | Corporate Director | Jul 1, 2024 | 10.5% |
| Pamela Steitz | Corporate Director | Sep 1, 2021 | 10.5% |
| Liberty Lutheran Services | 5% Or Greater Direct Ownership Interest | Jan 1, 2001 | 100% |
| Operational/Managerial Control | Jan 1, 2001 | 100% | |
| Adp of the SNF | Jan 1, 2001 | ||
| Dave Stettler | Corporate Director | Nov 1, 2016 | 10.5% |
| Linda a Breckenridge | Corporate Director | Sep 1, 2019 | 10.5% |
| Michael D Galante | Operational/Managerial Control | Aug 13, 2007 | |
| Adp of the SNF | Aug 13, 2007 | ||
| Powerback Rehabilitation LLC | Adp of the SNF | Jul 1, 2024 | |
| Wayne Matthias-Long | Corporate Director | Sep 1, 2021 | 10.5% |
| Morgan Stanley | Adp of the SNF | Jul 1, 2024 | |
| Kreisher Miller | Adp of the SNF | Mar 31, 2025 | |
| Intelycare Inc | Adp of the SNF | Dec 21, 2022 | |
| Twomagnets LLC | Adp of the SNF | Jul 1, 2024 | |
| Loyal Assistant, Inc. | Adp of the SNF | Jul 1, 2024 | |
| Luanne B Fisher | Corporate Officer | Jan 2, 1977 | 4% |
| Adp of the SNF | Jan 2, 1977 | ||
| Kimberly C Griffies-Edwards | Operational/Managerial Control | Dec 2, 2024 | |
| Adp of the SNF | Dec 2, 2024 | ||
| Curana Health of Pennsylvania PC | Adp of the SNF | Feb 15, 2024 | |
| Joan M Myers | Corporate Officer | Feb 9, 1987 | 4% |
| Adp of the SNF | Feb 9, 1987 | ||
| Frank Beech III | Operational/Managerial Control | Jan 2, 2025 | |
| Adp of the SNF | Jan 2, 2025 | ||
| Baker Tilly Advisory Group LP | Adp of the SNF | Jul 1, 2024 | |
| Bank of America Corp | Adp of the SNF | Aug 16, 2006 | |
| Beverly Bortz | Corporate Director | Sep 1, 2012 | 10.5% |
| James Himler | Corporate Director | Sep 1, 2016 | 10.5% |
| RKL LLP | Adp of the SNF | Jul 1, 2024 | |
| John M Barnum | Corporate Officer | Apr 10, 2006 | 4% |
| Adp of the SNF | Apr 10, 2006 | ||
| Frank Roth | Corporate Director | Jul 9, 2025 | 10.5% |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Allentown, PA
- NPI 1679205876
Adp of the SNF
-
- Family Medicine Physician
- Philadelphia, PA
- NPI 1023638459
Adp of the SNF
Facilities with the same owner 2
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- State College, PA
- NPI 1952392193
Liberty Lutheran Services
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Philadelphia, PA
- NPI 1023638459
-
- Rheumatology Physician
- Blue Bell, PA
- NPI 1568818615
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Family Medicine Physician
- Philadelphia, PA
- NPI 1023638459
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123113600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1366443970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 N BETHLEHEM PIKE",
"city": "AMBLER",
"state": "PA",
"postal_code": "190023524",
"telephone_number": "215-643-6333",
"fax_number": "215-643-6791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9896 BUSTLETON AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191155202",
"telephone_number": "215-934-3000",
"fax_number": "215-934-3018"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PAUL'S RUN",
"organizational_subpart": "NO",
"enumeration_date": "2005-08-04",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "BARNUM",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "M.",
"authorized_official_title_or_position": "VP/CFO",
"authorized_official_telephone_number": "215-643-6333",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "PA",
"license": "176990",
"primary": true
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "PA",
"license": "161902",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMERC SUPPLIER #",
"identifier": "0908820001",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0012939630002",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.