NPIMap

Organization Active NPI

Decatur Operating Group LLC

  • Skilled Nursing Facility
  • Decatur, TN
National Provider Identifier
1396308508
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
DECATUR OPERATING GROUP LLC
Practice address
332 River Rd
Decatur, TN 37322-7800
Phone
(423) 334-3002
NPI assigned
Apr 15, 2019
Last updated
Apr 15, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

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

Authorized official

Name
Anshel Niederman
Title
Manager
Phone
(929) 900-2005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

332 River Rd
Decatur, TN 37322-7800

Mailing address

544 Park Ave Ste B04
Brooklyn, NY 11205-1670
Phone (917) 682-3129

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190821004099 TN Part A Provider - Skilled Nursing Facility 9931437431 Practice locations: Decatur, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396308508. Details of each certification follow.

Skilled nursing facility certification: CCN 445529

Legal name
DECATUR OPERATING GROUP LLC
Doing business as
DECATUR WELLNESS AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 29, 2017
Last certification
Aug 30, 2022
Beds
88
Ownership / control type
Corporation
Multi-facility organization
Ahava Healthcare
Organization structure
LLCProprietary
Enrollment address
332 River Rd
Decatur, TN 37322-7800
Nursing home name
DECATUR WELLNESS AND REHABILITATION CENTER
Affiliated entity
AHAVA HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Decatur Wellness and Rehabilitation CenterCCN 445529 · All quality measures
Overall star rating
3 of 5
Health inspections
4 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Nov 29, 2017
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8858.8 residents per day on average
Chain
Ahava Healthcare16 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D0659081Decatur Operating Group, LLC332 River Road, Decatur, TN 37322Certificate of waiverJul 21, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Benjamin Neuman Individual 5% Or Greater Indirect Ownership Interest Jun 1, 2019 10%
Avi Philipson Individual Other Mar 21, 2023 3.34%
Bent Philipson Individual 5% Or Greater Indirect Ownership Interest Jun 1, 2019 10%
Ecm Holdings LLC Organization, Brooklyn, NY LLC, For-profit 5% Or Greater Indirect Ownership Interest Jun 1, 2019 10%
Megan Wiggins Individual W-2 Managing EmployeeDirector of Nursing Jun 1, 2019
Shiya Labin Individual 5% Or Greater Indirect Ownership Interest Jun 1, 2019 10%
Anshel Niederman Individual 5% Or Greater Indirect Ownership Interest Jun 1, 2019 50%
Corporate OfficerManager Jun 1, 2019
Raquel Philipson Individual Other Mar 21, 2023 3.33%
Philipson Family Limited Liability Company, LLC Organization, Spring Valley, NY LLC, For-profit 5% Or Greater Indirect Ownership Interest Jun 1, 2019 20%
VNB New York LLC Organization, New York, NY LLC, Financial institution, For-profit 5% Or Greater Security Interest Jun 1, 2019
Linda Sherlin Individual W-2 Managing EmployeeAdministrator Jun 1, 2019
Menashe Eisen Individual 5% Or Greater Indirect Ownership Interest Jun 1, 2019 10%
Gabrielle Philipson Individual Other Mar 21, 2023 3.33%
Decatur Holdco LLC Organization, Brooklyn, NY LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Jun 1, 2019 100%

Facilities with the same owner 29

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

View all 29

Practitioners & affiliated clinicians

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.

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555286400000",
    "number": "1396308508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 PARK AVE STE B04",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112051670",
            "telephone_number": "917-682-3129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 RIVER RD",
            "city": "DECATUR",
            "state": "TN",
            "postal_code": "373227800",
            "telephone_number": "423-334-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR OPERATING GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-15",
        "last_updated": "2019-04-15",
        "status": "A",
        "authorized_official_last_name": "NIEDERMAN",
        "authorized_official_first_name": "ANSHEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "929-900-2005"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, TN

Sources for this page

Verify at the official NPI Registry.