NPIMap

Organization Active NPI

Burbank Parke Care Center, Inc.

  • Skilled Nursing Facility
  • Burbank, OH
National Provider Identifier
1467689976
Registry record updated Dec 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
BURBANK PARKE CARE CENTER, INC.
Practice address
14976 Burbank Rd
Burbank, OH 44214-9763
Phone
(330) 624-1030
Fax
(440) 385-4371
NPI assigned
Jun 11, 2009
Last updated
Dec 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2010

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

Authorized official

Name
Mr. David Franklin Cooley
Title
Chief Financial Officer
Phone
(440) 385-4375

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

14976 Burbank Rd
Burbank, OH 44214-9763

Mailing address

159 Crocker Park Blvd
Suite 400
Westlake, OH 44145-8131
Phone (440) 385-4370

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100104000559 OH Part A Provider - Skilled Nursing Facility 3779624440 Practice locations: Burbank, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467689976. Details of each certification follow.

Skilled nursing facility certification: CCN 366392

Legal name
BURBANK PARKE CARE CENTER, INC.
Doing business as
BURBANK PARKE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 16, 2010
Last certification
Dec 29, 2023
Beds
81
Ownership / control type
Corporation
Multi-facility organization
JAG Healthcare
Organization structure
CorporationProprietary
Enrollment address
14976 Burbank Rd
Burbank, OH 44214-8700
Nursing home name
BURBANK PARKE CARE CENTER
Affiliated entity
JAG HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Burbank Parke Care CenterCCN 366392 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Sep 16, 2010
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8176.4 residents per day on average
Chain
Jag Healthcare9 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
36D2009336Burbank Parke Care Center Dba14976 Burbank Road, Burbank, OH 44214Certificate of waiverJun 29, 2028

National Provider Directory

National Provider Directory

Locations

14976 Burbank Rd
Burbank, OH 44214
Phone (330) 624-1030

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Shobha Khandelwal Individual Operational/Managerial Control Sep 16, 2010
Adp of the SNF Sep 16, 2010
Jag Healthcare Inc Organization, Rocky River, OH Corporation, For-profit, Chain home office Operational/Managerial Control Aug 1, 2013 100%
Adp of the SNF Aug 1, 2013
Lauren Fiser Individual Operational/Managerial Control May 1, 2023
Adp of the SNF May 1, 2023
Burbank Park Re, LLC Organization, Rocky River, OH Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Mortgage Interest Aug 1, 2017 62%
Operational/Managerial Control Aug 1, 2017
Adp of the SNF Aug 1, 2017
James Griffiths Individual 5% Or Greater Direct Ownership Interest Aug 1, 2013 100%
Corporate OfficerCeo Sep 4, 2013 100%
Operational/Managerial Control Aug 1, 2013
Adp of the SNF Aug 1, 2013

Owners & managing parties with NPI records 1

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

Facilities with the same owner 8

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, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 1

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": "1244678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291161600000",
    "number": "1467689976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 CROCKER PARK BLVD",
            "address_2": "SUITE 400",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441458131",
            "telephone_number": "440-385-4370",
            "fax_number": "440-385-4371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14976 BURBANK RD",
            "city": "BURBANK",
            "state": "OH",
            "postal_code": "442149763",
            "telephone_number": "330-624-1030",
            "fax_number": "440-385-4371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURBANK PARKE CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-11",
        "last_updated": "2010-12-01",
        "status": "A",
        "authorized_official_last_name": "COOLEY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "FRANKLIN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "440-385-4375",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, OH

Sources for this page

Verify at the official NPI Registry.