NPIMap

Organization Active NPI

Shane Hill Rehabilitation and Nursing Center LLC

Doing business as Divine Rehabilitation and Nursing Center at Shane Hill

  • Skilled Nursing Facility
  • Rockford, OH
National Provider Identifier
1376144782
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SHANE HILL REHABILITATION AND NURSING CENTER LLC
Doing business as
Divine Rehabilitation and Nursing Center at Shane Hill
Practice address
10731 State Route 118
Rockford, OH 45882-8947
Phone
(419) 363-2620
NPI assigned
Nov 3, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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

Authorized official

Name
Isaak Markovits
Title
Cfo
Phone
(608) 448-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

10731 State Route 118
Rockford, OH 45882-8947

Mailing address

1080 McDonald Ave Ste 213
Brooklyn, NY 11230-2633
Phone (608) 448-6200

Other names 1

  • Divine Rehabilitation and Nursing Center at Shane Hill Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210115002282 OH Part A Provider - Skilled Nursing Facility 9638582414 Practice locations: Rockford, OH

Skilled nursing facility certification: CCN 366125

Legal name
SHANE HILL REHABILITATION AND NURSING CENTER LLC
Doing business as
DIVINE REHABILITATION AND NURSING AT SHANE HILL
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 30, 1997
Last certification
Apr 10, 2024
Beds
69
Ownership / control type
Corporation
Multi-facility organization
DIVINE HEALTHCARE MANAGEMENT
Most recent change of ownership
Dec 1, 2020
Organization structure
LLCProprietary
Incorporated
Oct 11, 2020 in OH
Enrollment address
10731 Oh 118
Rockford, OH 45882
Nursing home name
DIVINE REHABILITATION AND NURSING AT SHANE HILL
Affiliated entity
DIVINE HEALTHCARE MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Divine Rehabilitation and Nursing at Shane HillCCN 366125 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Apr 30, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6963.2 residents per day on average
Chain
Divine Healthcare Management9 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
DHM Oh Three Holdings LLC Organization, Brooklyn, NY LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Dec 1, 2020 100%
Isaak Markovits Individual 5% Or Greater Indirect Ownership Interest Dec 1, 2020 50%
Corporate OfficerManager Dec 1, 2020
Operational/Managerial ControlManager Dec 1, 2020
Ilan Richland Individual 5% Or Greater Indirect Ownership Interest Dec 1, 2020 50%
Corporate OfficerManager Dec 1, 2020

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604361600000",
    "number": "1376144782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 MCDONALD AVE STE 213",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112302633",
            "telephone_number": "608-448-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10731 STATE ROUTE 118",
            "city": "ROCKFORD",
            "state": "OH",
            "postal_code": "458828947",
            "telephone_number": "419-363-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANE HILL REHABILITATION AND NURSING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-03",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A",
        "authorized_official_last_name": "MARKOVITS",
        "authorized_official_first_name": "ISAAK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "608-448-6200"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Divine Rehabilitation and Nursing Center at Shane Hill",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockford, OH

Sources for this page

Verify at the official NPI Registry.