NPIMap

Organization Active NPI

Majestic Care of Columbus LLC

  • Skilled Nursing Facility
  • Columbus, OH
National Provider Identifier
1497310395
Registry record updated May 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MAJESTIC CARE OF COLUMBUS LLC
Practice address
44 S Souder Ave
Columbus, OH 43222-1539
Phone
(614) 228-5900
NPI assigned
May 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2019

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

Authorized official

Name
Joseph Lieberman
Title
Officer
Phone
(718) 380-8882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

44 S Souder Ave
Columbus, OH 43222-1539

Mailing address

1950 Rutgers University Blvd Ste 201
Lakewood, NJ 08701-4537
Phone (732) 702-6498

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190715002206 OH Part A Provider - Skilled Nursing Facility 7416282389 Practice locations: Columbus, OH

Skilled nursing facility certification: CCN 365754

Legal name
MAJESTIC CARE OF COLUMBUS LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 21, 1989
Last certification
Jun 12, 2025
Beds
120
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Majestic Care
Organization structure
LLCProprietary
Incorporated
Jan 18, 2019 in OH
Enrollment address
44 S Souder Ave
Columbus, OH 43222-1539
Nursing home name
MAJESTIC CARE OF COLUMBUS LLC
Affiliated entity
MAJESTIC CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Majestic Care of Columbus LLCCCN 365754
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 - Limited Liability company
Certified
Sep 21, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12066.7 residents per day on average
Chain
Majestic Care22 facilities in the chain
Penalties (3 years)
3Fines totaling $111,283

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
36D0858625Majestic Care of Columbus44 S Souder Avenue, Columbus, OH 43222Certificate of waiverAug 31, 2026

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
Majestic Management LLC Organization, Westfield, IN LLC, Management services company, For-profit Operational/Managerial Control Jun 1, 2019
Adp of the SNF Oct 22, 2025
MDG Majestic Ohio Operations Holdings LLC Organization, Flushing, NY Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 1, 2019 100%
Angela Rewa Individual Operational/Managerial Control Oct 23, 2023
Adp of the SNF Oct 23, 2023
MDG Majestic Ohio Property Holdings LLC Organization, Flushing, NY LLC Operational/Managerial Control Jun 1, 2019
Adp of the SNF Jun 1, 2019
Vincent K Chu Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Robert Laron Russell Individual Operational/Managerial Control Apr 8, 2024
Adp of the SNF Apr 8, 2024
Timothy Ross Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Paul Pruitt Individual Operational/Managerial Control May 1, 2023
Managing Control - Governing BodyCeo May 1, 2023
Adp of the SNF May 1, 2023
Margaret Chamberlain Individual Operational/Managerial Control Sep 11, 2023
Adp of the SNF Sep 11, 2023
Anzhelika Shatrov Individual Operational/Managerial Control Dec 2, 2024
Adp of the SNF Dec 2, 2024
David Marx Individual 5% Or Greater Indirect Ownership InterestSole Owner Jun 1, 2019 100%
Adp of the SNF Jun 1, 2019
Organization, Flushing, NY LLC Adp of the SNF Jun 1, 2019
Organization, Flushing, NY LLC Adp of the SNF Jun 1, 2019
Eric Wolfe Individual Operational/Managerial Control Sep 11, 2023
Adp of the SNF Sep 11, 2023

Owners & managing parties with NPI records 2

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

Facilities with the same owner 20

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

View all 20

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 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": "1557100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557100800000",
    "number": "1497310395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 RUTGERS UNIVERSITY BLVD STE 201",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014537",
            "telephone_number": "732-702-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 S SOUDER AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221539",
            "telephone_number": "614-228-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAJESTIC CARE OF COLUMBUS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-06",
        "last_updated": "2019-05-06",
        "status": "A",
        "authorized_official_last_name": "LIEBERMAN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "718-380-8882"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.