NPIMap

Organization Active NPI

Kingston Care Center of Sylvania, LLC

  • Skilled Nursing Facility
  • Sylvania, OH
National Provider Identifier
1477540649
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
2418N Issued in OH
Legal business name
KINGSTON CARE CENTER OF SYLVANIA, LLC
Practice address
4121 King Rd
Sylvania, OH 43560-4438
Phone
(419) 517-8200
Fax
(419) 517-8201
NPI assigned
Oct 4, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Larry Nirschl
Title
Treasurer of Managing Member
Phone
(419) 247-2824

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 2418N OH Primary

Addresses

Primary practice location

4121 King Rd
Sylvania, OH 43560-4438

Mailing address

PO Box 2165
Toledo, OH 43603-2165
Phone (419) 247-2880

Other identifiers 1

IdentifierTypeStateIssuer
2526038MedicaidOH

Other names 1

  • Kingston Care Center of Sylvania Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041014000959 OH Part A Provider - Skilled Nursing Facility 9032179916 Practice locations: Sylvania, OH

Skilled nursing facility certification: CCN 366305

Legal name
KINGSTON CARE CENTER OF SYLVANIA, LLC
Doing business as
KINGSTON CARE CENTER OF SYLVANIA
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 10, 2005
Last certification
Jun 8, 2023
Beds
127
Ownership / control type
Limited Liability Corporation
Multi-facility organization
KINGSTON
Organization structure
LLCProprietary
Incorporated
Aug 2, 2001 in OH
Enrollment address
4121 King Rd
Sylvania, OH 43560-4438

Care Compare: Nursing home

Medicare Care Compare
Listed as
Kingston Health Center of SylvaniaCCN 366305
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 10, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
127120.3 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Kingston Healthcare Inc Organization, Toledo, OH For-profit 5% Or Greater Direct Ownership Interest Jan 1, 2006 100%
Jeffrey H Miller Individual Corporate DirectorBoard Member Mar 7, 2012
Benjamin Perkins Individual W-2 Managing EmployeeAdministrator Feb 25, 2019
Mari Warburton Individual Corporate DirectorDirector Mar 4, 2019
Christine Nichols Individual 5% Or Greater Indirect Ownership InterestShareholder Jul 6, 2011 12.55%
Corporate Director Apr 5, 2020
Michael Rumman Individual Corporate DirectorBoard Member Jan 1, 2006
George Rumman Individual 5% Or Greater Indirect Ownership InterestPresident Jul 10, 2010 37.27%
Corporate OfficerPresident, Ceo & Treasurer Dec 31, 2005
Corporate DirectorBoard Member Jan 1, 2006
Robert Baxter Individual Corporate DirectorDirector Apr 1, 2019
Kingston Healthcare Company LLC Organization, Toledo, OH LLC Operational/Managerial Control Jan 1, 2006
Sara Louk Individual Operational/Managerial ControlRegional Manager May 14, 2016
Kent Libbe Individual Corporate OfficerVice President and Secretary Dec 31, 2005
Diane French Individual Corporate OfficerSecretary of the Board Jun 9, 2020
W-2 Managing EmployeeIn-House Counsel Jan 14, 2019
Jill Biedenharn Individual W-2 Managing EmployeeDirectory of Finance and Accounting Jan 25, 2016
Operational/Managerial ControlDirectory of Finance and Accounting Jan 25, 2016
Frederica R Wolfe Individual 5% Or Greater Indirect Ownership InterestShareholder Jul 6, 2011
William Nichols Individual Corporate DirectorBoard Member Jan 1, 2006
Bruce H Dukeman Individual Corporate DirectorBoard Member Jan 1, 2006
Elizabeth Wolfe Individual 5% Or Greater Indirect Ownership InterestShareholder Jul 6, 2011 8.33%

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 3

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

Affiliated clinicians 4

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": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477540649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2165",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436032165",
            "telephone_number": "419-247-2880",
            "fax_number": "419-247-2872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 KING RD",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435604438",
            "telephone_number": "419-517-8200",
            "fax_number": "419-517-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSTON CARE CENTER OF SYLVANIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NIRSCHL",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "TREASURER OF MANAGING MEMBER",
        "authorized_official_telephone_number": "419-247-2824",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "2418N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2526038",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kingston Care Center of Sylvania",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.