The Good Shepherd Home for the Aged

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

000472N Issued in OH

Legal business name

THE GOOD SHEPHERD HOME FOR THE AGED

Practice address

622 Center St
Ashland, OH 44805-3343

Phone

(419) 289-3523

Fax

(419) 281-0656

NPI assigned

Jul 20, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thomas James Stofac

Title

President & Ceo

Phone

(614) 228-5200

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487653457. Details of each certification follow.

• CCN 365093 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 365093

Legal name

THE GOOD SHEPHERD HOME FOR THE AGED

Doing business as

HUNTINGTON NATIONAL BANK

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 1, 1967

Last certification

Jul 18, 2024

Beds

125

Ownership / control type

Corporation

Organization structure

CorporationNon-profit

Incorporated

Mar 8, 1956 in OH

Enrollment address

622 Center St
Ashland, OH 44805-3343

Nursing home name

THE GOOD SHEPHERD HEALTH AND REHABILITATION CENTER

Listed as

The Good Shepherd Health and Rehabilitation CenterCCN 365093 · All quality measures

Overall star rating

5 of 5

Health inspections

4 of 5

Staffing

4 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Jan 1, 1967

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

125113.2 residents per day on average

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Lutheran Social Services of Central Ohio, Inc

  dba Health Center at Faith Mission

  • Federally Qualified Health Center (FQHC)
  • Columbus, OH
  • NPI 1801317102

  Member Of

  NPD member

All disclosed owners & managing parties 37

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 2

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

• Lutheran Social Services of Central Ohio, Inc

  dba Health Center at Faith Mission

  • Federally Qualified Health Center (FQHC)
  • Columbus, OH
  • NPI 1801317102

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

  CMS ownership
• Mehrdad Tavallaee, MD

  • Internal Medicine Physician
  • Ashland, OH
  • NPI 1689625634

  Adp of the SNF, Operational/Managerial Control

  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.

• Mehrdad Tavallaee, MD

  • Internal Medicine Physician
  • Ashland, OH
  • NPI 1689625634
  NPD (past)

Affiliated clinicians 1

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

• Mehrdad Tavallaee, MD

  • Internal Medicine Physician
  • Ashland, OH
  • NPI 1689625634

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487653457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 CENTER ST",
            "city": "ASHLAND",
            "state": "OH",
            "postal_code": "448053343",
            "telephone_number": "419-289-3523",
            "fax_number": "419-281-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 CENTER ST",
            "city": "ASHLAND",
            "state": "OH",
            "postal_code": "448053343",
            "telephone_number": "419-289-3523",
            "fax_number": "419-281-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GOOD SHEPHERD HOME FOR THE AGED",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STOFAC",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "614-228-5200"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "000472N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0025850",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Ashland, OH
• Providers in Ashland, 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 Aug 22, 2020; 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.