Active NPI
Embassy Winchester, LLC
- Skilled Nursing Facility
- Canal Winchester, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- EMBASSY WINCHESTER, LLC
- Practice address
- 36 Lehman Dr
Canal Winchester, OH 43110-1006 - Phone
- (614) 834-2273
- NPI assigned
- Mar 2, 2020
- Last updated
- Mar 2, 2020
- 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
- Hayley Williams
- Title
- Attorney
- Phone
- (216) 978-0268
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
36 Lehman Dr
Canal Winchester, OH 43110-1006
Mailing address
945 Broadway
Woodmere, NY 11598-1733
Phone (516) 869-3700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598N | Other | OH | LICENSURE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200409003557 | OH | Part A Provider - Skilled Nursing Facility | 9032548565 | Practice locations: Canal Winchester, OH |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1548894330. Details of each certification follow.
Skilled nursing facility certification: CCN 365644
- Legal name
- EMBASSY WINCHESTER, LLC
- Doing business as
- EMBASSY OF WINCHESTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 4, 1985
- Last certification
- Dec 5, 2024
- Beds
- 176
- Ownership / control type
- Corporation
- Multi-facility organization
- Embassy Healthcare
- Most recent change of ownership
- Mar 1, 2020
- Organization structure
- LLC
- Incorporated
- Jan 21, 2020 in OH
- Enrollment address
- 36 Lehman Dr
Canal Winchester, OH 43110-1006 - Nursing home name
- EMBASSY OF WINCHESTER
- Affiliated entity
- EMBASSY HEALTHCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Embassy of Winchester
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jan 4, 1985
- Medicare certification status
- Active
- Certified beds
- 176
- Chain
- Embassy Healthcare
- Penalties (3 years)
- 2
National Provider Directory
National Provider DirectoryLocations
36 Lehman Dr
Canal Wnchstr, OH 43110
Phone (614) 834-2273
Ownership & related parties
All disclosed owners & managing parties 3
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 |
|---|---|---|---|
| Dashae Hooper | W-2 Managing Employee | Mar 1, 2020 | 100% |
| Benjamin Landa | 5% Or Greater Direct Ownership Interest | Mar 1, 2020 | 100% |
| George S. Repchick | Corporate Officer | Mar 1, 2020 | 100% |
| Corporate Director | Mar 1, 2020 | 100% |
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Internal Medicine Physician
- Columbus, OH
- NPI 1174910228
-
- Family Medicine Physician
- Columbus, OH
- NPI 1760445027
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": "1583107200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1583107200000",
"number": "1548894330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "945 BROADWAY",
"city": "WOODMERE",
"state": "NY",
"postal_code": "115981733",
"telephone_number": "516-869-3700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 LEHMAN DR",
"city": "CANAL WINCHESTER",
"state": "OH",
"postal_code": "431101006",
"telephone_number": "614-834-2273"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EMBASSY WINCHESTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-03-02",
"last_updated": "2020-03-02",
"certification_date": "2020-03-02",
"status": "A",
"authorized_official_last_name": "WILLIAMS",
"authorized_official_first_name": "HAYLEY",
"authorized_official_title_or_position": "ATTORNEY",
"authorized_official_telephone_number": "216-978-0268"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSURE",
"identifier": "1598N",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Canal Winchester, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.