Organization Active NPI

Kettering Nursing

  • Skilled Nursing Facility
  • Dayton, OH
National Provider Identifier
1558139857
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
KETTERING NURSING
Practice address
1150 W Dorothy LN
Dayton, OH 45409-1305
Phone
(937) 293-1152
NPI assigned
Dec 15, 2023
Last updated
Dec 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Authorized official

Name
Nate Shap
Title
Member
Phone
(937) 293-1152

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1150 W Dorothy LN
Dayton, OH 45409-1305

Mailing address

1150 W Dorothy LN
Dayton, OH 45409-1305

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240510001337 OH Part A Provider - Skilled Nursing Facility 2668813452 Practice locations: Dayton, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1558139857. Details of each certification follow.

Skilled nursing facility certification: CCN 365321

Legal name
KETTERING NURSING
Doing business as
THE OAKS OF WEST KETTERING
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 31, 1974
Last certification
Jul 30, 2024
Beds
118
Ownership / control type
Corporation
Most recent change of ownership
Dec 31, 2023
Organization structure
LLCProprietary
Incorporated
Jul 3, 2023 in OH
Enrollment address
1150 W Dorothy LN
Dayton, OH 45409-1305
Nursing home name
OAKS OF WEST KETTERING THE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Oaks of West Kettering theCCN 365321 · All quality measures
Overall star rating
2 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Mar 31, 1974
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
118107.2 residents per day on average
Penalties (3 years)
4Fines totaling $75,572

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

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.

NameRoleSinceShare
Sarah Maddix Individual Operational/Managerial Control Dec 31, 2023
Adp of the SNF Dec 31, 2023
Robert L Hunter Individual Operational/Managerial Control Dec 31, 2023
Adp of the SNF Dec 31, 2023
Naftali Shapiro Individual 5% Or Greater Indirect Ownership InterestCfo Dec 31, 2023 19%
Corporate OfficerCfo Dec 31, 2023 19%
Operational/Managerial Control Dec 31, 2023
Adp of the SNF Dec 31, 2023
Kettering Holdings LLC Organization, Dayton, OH Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Dec 31, 2023 100%
Adp of the SNF Dec 31, 2023
Kettering Management Organization, Dayton, OH Management services company Operational/Managerial Control Dec 31, 2023 100%
Adp of the SNF Apr 9, 2025
Kettering Opco Organization, Dayton, OH Created for acquisition, LLC 5% Or Greater Indirect Ownership Interest Dec 31, 2023 81%

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 1

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.

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": "1702598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702598400000",
    "number": "1558139857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 W DOROTHY LN",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454091305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 W DOROTHY LN",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454091305",
            "telephone_number": "937-293-1152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETTERING NURSING",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-15",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A",
        "authorized_official_last_name": "SHAP",
        "authorized_official_first_name": "NATE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "937-293-1152"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.