Shelby County Ohio

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SHELBY COUNTY OHIO

Doing business as

Fair Haven Shelby County Home

Practice address

2901 Fair Rd
Sidney, OH 45365-9534

Phone

(937) 492-6900

NPI assigned

Jan 4, 2007

Last updated

Apr 19, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

SHELBY COUNTYAs reported in NPPES

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

Authorized official

Name

Anita S. Miller, LNHA

Title

Executive Director

Phone

(937) 492-6900

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Fair Haven Shelby County Home Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376690461. Details of each certification follow.

• CCN 366235 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 366235

Legal name

SHELBY COUNTY OHIO

Doing business as

FAIRHAVEN SHELBY COUNTY HOME

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Mar 2, 2002

Last certification

Oct 20, 2022

Beds

90

Ownership / control type

County

Organization structure

GovernmentNon-profit

Enrollment address

2901 Fair Road
Sidney, OH 45365

Nursing home name

FAIR HAVEN SHELBY COUNTY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Shelby County Ohio

  dba Sidney-Shelby County Health Dept

  • Public Health or Welfare Agency
  • Sidney, OH
  • NPI 1477656601

  8325234974

  Same PAC ID

Listed as

Fair Haven Shelby CountyCCN 366235 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

4 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Government - County

Certified

Mar 2, 2002

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

9063.4 residents per day on average

Special focus status

SFF Candidate

Penalties (3 years)

1Fines totaling $0

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Sidney Shelby Co HLTH Dept4 organizations share this tax ID, including this one

Part of

Sidney Shelby Co HLTH Dept

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Adult Day Services of Shelby County

  • Public Health or Welfare Agency
  • Sidney, OH
  • NPI 1730464306
  NPD tax ID
• Nutrition Services of Shelby County

  • Home Delivered Meals
  • Sidney, OH
  • NPI 1467737049
  NPD tax ID
• Shelby County Board of MRDD

  • Developmentally Disabled Services Day Training Agency
  • Sidney, OH
  • NPI 1184742793
  NPD tax ID

All disclosed owners & managing parties 4

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Shelby County Ohio

  dba Sidney-Shelby County Health Dept

  • Public Health or Welfare Agency
  • Sidney, OH
  • NPI 1477656601

  5% Or Greater Direct Ownership Interest, Adp of the SNF

  CMS ownership

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.

• Miguel Topalov, MD

  • Internal Medicine Physician
  • Sidney, OH
  • NPI 1649296443
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Miguel Topalov, MD

  • Internal Medicine Physician
  • Sidney, OH
  • NPI 1649296443

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334793600000",
    "number": "1376690461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 FAIR RD",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453659534",
            "telephone_number": "937-492-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 FAIR RD",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453659534",
            "telephone_number": "937-492-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELBY COUNTY OHIO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHELBY COUNTY",
        "enumeration_date": "2007-01-04",
        "last_updated": "2012-04-19",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "937-492-6900",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0270111",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fair Haven Shelby County Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shelby County Memorial Hospital Assoc (Wilson Memorial Hospital)
• Shelby County Memorial Hospital Association
• Shelby County Memorial Hospital Association
• Shelby County Memorial Hospital Association Inc. (Wilson Memorial Hospital)
• Shelby County Memorial Hospital Association Inc. (Wilson Health)
• Shelby County Ohio (Sidney-Shelby County Health Dept)
• Shelby County Recovery Inc.
• Shelby County Surgical Assoc Inc
• Shelby Pediatrics, LLC
• Emily Marie Sherwood, LPCC

• Skilled Nursing Facility in Sidney, OH
• Providers in Sidney, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.

Verify at the official NPI Registry.