Active NPI
Fairport Enterprises, Inc.
- Skilled Nursing Facility
- Massillon, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 2082N
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0283787 | Medicaid | OH |
Other names 1
- THE LAURELS OF MASSILLON
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Other
- 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 Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Parenteral & Enteral Nutrition Supplies (DME)
- Massillon, OH
- NPI 1598847097
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.
| Name | Role | Since | Share |
|---|---|---|---|
| David Stobb | Corporate Officer | Feb 1, 2016 | 100% |
| Adp of the SNF | Feb 1, 2016 | ||
| Anis Khan | Operational/Managerial Control | Feb 1, 2016 | |
| Adp of the SNF | Feb 1, 2016 | ||
| Laurel Acquisition Holding Corporation | 5% Or Greater Indirect Ownership Interest | Feb 1, 2016 | 100% |
| Mohammad a. Qazi | 5% Or Greater Indirect Ownership Interest | Feb 1, 2016 | 100% |
| Corporate Officer | Feb 1, 2016 | 100% | |
| Corporate Director | Feb 1, 2016 | 100% | |
| Operational/Managerial Control | Feb 1, 2016 | ||
| Mohammad a Qazi Living Trust Dated 09/26/97 | 5% Or Greater Indirect Ownership Interest | Feb 1, 2016 | 100% |
| Laurel Health Care Company | Operational/Managerial Control | Jan 1, 2016 | |
| Adp of the SNF | Apr 1, 2025 | ||
| Laurel Health Care Holdings, Inc. | 5% Or Greater Direct Ownership Interest | Feb 1, 2016 | 100% |
| Brice Powell | Operational/Managerial Control | Apr 1, 2024 | |
| Adp of the SNF | Apr 1, 2024 | ||
| Adp of the SNF | Apr 1, 2025 | ||
| James Franz | Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Jan 1, 2025 | ||
| 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.
-
- Family Medicine Physician
- Canton, OH
- NPI 1467896100
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 67
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Athens, OH
- NPI 1033405170
Laurel Acquisition Holding Corporation, Laurel Health Care Company, Laurel Health Care Holdings, Inc., Mohammad a Qazi Living Trust Dated 09/26/97
-
- Skilled Nursing Facility
- Worthington, OH
- NPI 1285689562
Laurel Acquisition Holding Corporation, Laurel Health Care Company, Laurel Health Care Holdings, Inc., Mohammad a Qazi Living Trust Dated 09/26/97
-
- Skilled Nursing Facility
- Worthington, OH
- NPI 1215983275
Laurel Acquisition Holding Corporation, Laurel Health Care Company, Laurel Health Care Holdings, Inc., Mohammad a Qazi Living Trust Dated 09/26/97
-
- Skilled Nursing Facility
- Steubenville, OH
- NPI 1184848293
Laurel Acquisition Holding Corporation, Laurel Health Care Company, Laurel Health Care Holdings, Inc., Mohammad a Qazi Living Trust Dated 09/26/97
-
- Skilled Nursing Facility
- Defiance, OH
- NPI 1245285337
Laurel Acquisition Holding Corporation, Laurel Health Care Company, Laurel Health Care Holdings, Inc., Mohammad a Qazi Living Trust Dated 09/26/97
-
- Skilled Nursing Facility
- Mount Vernon, OH
- NPI 1316993355
Laurel Acquisition Holding Corporation, Laurel Health Care Company, Laurel Health Care Holdings, Inc., Mohammad a Qazi Living Trust Dated 09/26/97
-
- Skilled Nursing Facility
- Blanchester, OH
- NPI 1992032148
Laurel Acquisition Holding Corporation, Laurel Health Care Company, Laurel Health Care Holdings, Inc., Mohammad a Qazi Living Trust Dated 09/26/97
-
- Skilled Nursing Facility
- Chagrin Falls, OH
- NPI 1457873184
Laurel Health Care Company, Mohammad a Qazi Living Trust Dated 09/26/97
-
- Skilled Nursing Facility
- Columbus, OH
- NPI 1720583578
Laurel Acquisition Holding Corporation, Laurel Health Care Company, Laurel Health Care Holdings, Inc., Mohammad a Qazi Living Trust Dated 09/26/97
-
- Skilled Nursing Facility
- Hamilton, OH
- NPI 1346745197
Laurel Acquisition Holding Corporation, Laurel Health Care Company, Laurel Health Care Holdings, Inc.
-
- Skilled Nursing Facility
- Heath, OH
- NPI 1851896419
Laurel Acquisition Holding Corporation, Laurel Health Care Company, Laurel Health Care Holdings, Inc., Mohammad a Qazi Living Trust Dated 09/26/97
-
- Skilled Nursing Facility
- Huber Heights, OH
- NPI 1871938555
Laurel Acquisition Holding Corporation, Laurel Health Care Company, Laurel Health Care Holdings, Inc., Mohammad a Qazi Living Trust Dated 09/26/97
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Canton, OH
- NPI 1467896100
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, the
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Aug 14, 1996
- Medicare certification status
- Active
- Certified beds
- 140
- Chain
- Ciena Healthcare/Laurel Health Care
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; 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.