Organization Active NPI

Fairport Enterprises, Inc.

  • Skilled Nursing Facility
  • Massillon, OH
National Provider Identifier
1497701445
Registry record updated Jun 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
2082N Issued in OH
Legal business name
FAIRPORT ENTERPRISES, INC.
Practice address
2000 Sherman Cir NE
Massillon, OH 44646-5219
Phone
(330) 830-9988
Fax
(330) 830-0039
NPI assigned
May 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2016

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

Authorized official

Name
Mr. Anis Khan
Title
Cfo
Phone
(614) 794-8800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 2082N OH
Skilled Nursing Facility 314000000X 2082N OH Primary

Addresses

Primary practice location

2000 Sherman Cir NE
Massillon, OH 44646-5219

Mailing address

8181 Worthington Rd
Westerville, OH 43082-8067
Phone (614) 794-8800

Other identifiers 1

IdentifierTypeStateIssuer
0283787MedicaidOH

Other names 1

  • THE LAURELS OF MASSILLON Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060327000291 OH Part A Provider - Skilled Nursing Facility 0446268817 Practice locations: Massillon, OH

Skilled nursing facility certification: CCN 366078

Legal name
FAIRPORT ENTERPRISES, INC.
Doing business as
THE LAURELS OF MASSILLON
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 14, 1996
Last certification
May 18, 2023
Beds
140
Ownership / control type
Corporation
Multi-facility organization
Luarel Health Care
Organization structure
OtherProprietary
Incorporated
Feb 10, 1993 in OH
Enrollment address
2000 Sherman Necir
Massillon, OH 44646-5219
Nursing home name
LAURELS OF MASSILLON, THE
Affiliated entity
CIENA HEALTHCARE/LAUREL HEALTH CARE

National Provider Directory

National Provider Directory
Tax ID family
Fairport Enterprises Inc2 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.

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
David Stobb Individual Corporate OfficerSecretary Feb 1, 2016 100%
Adp of the SNF Feb 1, 2016
Anis Khan Individual Operational/Managerial Control Feb 1, 2016
Adp of the SNF Feb 1, 2016
Laurel Acquisition Holding Corporation Organization, Westerville, OH Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2016 100%
Mohammad a. Qazi Individual 5% Or Greater Indirect Ownership InterestPresident Feb 1, 2016 100%
Corporate OfficerPresident Feb 1, 2016 100%
Corporate DirectorPresident Feb 1, 2016 100%
Operational/Managerial Control Feb 1, 2016
Mohammad a Qazi Living Trust Dated 09/26/97 Organization, West Bloomfield, MI For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2016 100%
Laurel Health Care Company Organization, Westerville, OH Corporation, For-profit, Chain home office Operational/Managerial Control Jan 1, 2016
Adp of the SNF Apr 1, 2025
Laurel Health Care Holdings, Inc. Organization, Westerville, OH Corporation, For-profit 5% Or Greater Direct Ownership Interest Feb 1, 2016 100%
Brice Powell Individual Operational/Managerial Control Apr 1, 2024
Adp of the SNF Apr 1, 2024
Organization, Glenview, IL LLC, For-profit Adp of the SNF Apr 1, 2025
James Franz Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Organization, Taylor, MI LLC, For-profit Adp of the SNF Apr 1, 2025

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 67

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

View all 67

Practitioners 1

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.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Laurels of Massillon, theCCN 366078
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Aug 14, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
140132.6 residents per day on average
Chain
Ciena Healthcare/Laurel Health Care81 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466121600000",
    "number": "1497701445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8181 WORTHINGTON RD",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430828067",
            "telephone_number": "614-794-8800",
            "fax_number": "614-794-8826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 SHERMAN CIR NE",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446465219",
            "telephone_number": "330-830-9988",
            "fax_number": "330-830-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRPORT ENTERPRISES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2016-06-17",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "ANIS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "614-794-8800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "OH",
            "license": "2082N",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "2082N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0283787",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE LAURELS OF MASSILLON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Massillon, OH

Sources for this page

Verify at the official NPI Registry.