Gaslite Leasing, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

GASLITE LEASING, LLC

Practice address

7055 High Mill Ave. NW
Canal Fulton, OH 44614

Phone

(216) 854-4545

Fax

(866) 629-9730

NPI assigned

Oct 31, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Eli M. Gunzburg, LNHA

Title

Managing Member

Phone

(440) 658-1040

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Jackson Ridge Rehabilitation and Care Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth J Biros, DO

  • Family Medicine Physician
  • Canal Fulton, OH
  • NPI 1407819600
  NPD (past)

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419897600000",
    "number": "1366796161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29225 CHAGRIN BLVD.",
            "address_2": "SUITE 230",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44122",
            "telephone_number": "440-658-1040",
            "fax_number": "866-629-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7055 HIGH MILL AVE. NW",
            "city": "CANAL FULTON",
            "state": "OH",
            "postal_code": "44614",
            "telephone_number": "216-854-4545",
            "fax_number": "866-629-9730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASLITE LEASING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-31",
        "last_updated": "2014-12-30",
        "status": "A",
        "authorized_official_last_name": "GUNZBURG",
        "authorized_official_first_name": "ELI",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "440-658-1040",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0076444",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CCN",
            "identifier": "366271",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson Ridge Rehabilitation and Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karli Fahrni, PHARMD
• Family Medical Care Center
• Lori Ferguson
• Tara Fout
• Freedom Wellness Center LLC
• Gaslite Villa Convalescent Center, Inc.
• Denise Giroux, MPH, MS, RD, LD,
• Andrew Duane Goddard, RPH
• Cami G. Goucher, C.N.P.
• Nicole Marie Grant

• All providers in Canal Fulton, OH
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; 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.