Crestmont Nursing Home North Corp.

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

4284 Issued in OH

Legal business name

CRESTMONT NURSING HOME NORTH CORP.

Practice address

13330 Detroit Ave
Lakewood, OH 44107-2850

Phone

(216) 228-9550

Fax

(216) 521-2193

NPI assigned

Jun 1, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Elias J Coury

Title

Owner

Phone

(216) 539-7846

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Crestmont North Nursing Home Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Skilled nursing facility certification: CCN 365875

Legal name

CRESTMONT NURSING HOME NORTH CORP.

Doing business as

CRESTMONT NORTH NURSING HOME

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

May 22, 1992

Last certification

May 29, 2025

Beds

71

Ownership / control type

Individual

Organization structure

CorporationProprietary

Incorporated

Apr 23, 1986 in OH

Enrollment address

13330 Detroit Ave
Lakewood, OH 44107-2850

Nursing home name

CRESTMONT NORTH NURSING HOME

Listed as

Crestmont North Nursing HomeCCN 365875

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 - Individual

Certified

May 22, 1992

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

7158.4 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Crestmont North - Laboratory2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Crestmont Nursing Home North Corp

  • Clinical Medical Laboratory
  • Lakewood, OH
  • NPI 1831350610
  NPD tax ID

Locations

All disclosed owners & managing parties 6

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.

• Jayantilal D Bhimani, MD

  • Internal Medicine Physician
  • Cleveland, OH
  • NPI 1619943388

  Adp of the SNF

  CMS ownership

Facilities with the same owner 1

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

• Myocare Nursing Home, Inc.

  • Skilled Nursing Facility
  • Cleveland, OH
  • NPI 1497731541

  BHP Management Corporation

  CMS ownership

Practitioners 2

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

• Jayantilal D Bhimani, MD

  • Internal Medicine Physician
  • Cleveland, OH
  • NPI 1619943388
  NPD (past)
• Nitin Govani, MD

  • Internal Medicine Physician
  • Lakewood, OH
  • NPI 1619079050
  NPD (past)

Affiliated clinicians 1

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

• Nitin Govani, MD

  • Internal Medicine Physician
  • Lakewood, OH
  • NPI 1619079050

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664755200000",
    "number": "1487656773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13330 DETROIT AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441072850",
            "telephone_number": "216-539-7846",
            "fax_number": "216-521-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13330 DETROIT AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441072850",
            "telephone_number": "216-228-9550",
            "fax_number": "216-521-2193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTMONT NURSING HOME NORTH CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-01",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A",
        "authorized_official_last_name": "COURY",
        "authorized_official_first_name": "ELIAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-539-7846",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "OH",
            "license": "4284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0880793",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crestmont North Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Crestmont North Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole Margaret Craig, LSW
• David Crawford, DC
• Susan Crawford
• Elizabeth Crespo, CNP
• Crestmont Nursing Home North Corp
• Linda B Creviston
• April Charlotte Crone, LMT
• Bethany Crooms
• Janautica Cross
• Jesse M Crowder

• Nursing Facility/Intermediate Care Facility in Lakewood, OH
• Providers in Lakewood, OH by specialty
• Nursing Facility/Intermediate Care Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; 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.