Organization Active NPI

Odd Fellows Home of Connecticut

  • Rehabilitation Clinic/Center
  • Groton, CT
National Provider Identifier
1609393909
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
ODD FELLOWS HOME OF CONNECTICUT
Doing business as
Fairview
Practice address
235 Lestertown Rd
Groton, CT 06340-2808
Phone
(860) 445-7478
NPI assigned
Aug 28, 2017
Organization subpart
Yes
Parent organization
ODD FELLOWS HOME OF CONNECTICUT, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
James Rosenman
Title
Ceo
Phone
(860) 445-7478

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

235 Lestertown Rd
Groton, CT 06340-2808

Mailing address

235 Lestertown Rd
Groton, CT 06340-2808
Phone (860) 445-7478

Other practice location 1

107 Wilcox Rd Ste 107G
Stonington, CT 06378-2614
Phone (860) 445-7478

Other names 2

  • Fairview Doing business as
  • FairviewFirst Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111203000087 CT Part A Provider - Skilled Nursing Facility 4880869866 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Groton, CT

Skilled nursing facility certification: CCN 075288

Legal name
ODD FELLOWS HOME OF CONNECTICUT
Doing business as
FAIRVIEW
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 1979
Last certification
Jul 17, 2024
Beds
120
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Enrollment address
235 Lestertown Rd
Groton, CT 06340-2808
Nursing home name
FAIRVIEW

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Nursing home

Medicare Care Compare
Listed as
FairviewCCN 075288 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Oct 1, 1979
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12090.7 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Part of
Odd Fellows Home of Connecticut

Locations

107 Wilcox Rd
Ste 107G
Stonington, CT 06378
Phone (860) 445-7478

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Frederick Yeo Individual Operational/Managerial Control Feb 1, 2024
Adp of the SNF Feb 1, 2024
Linda Stein Individual Corporate DirectorDirector Jun 11, 2011
William Nelson Individual Corporate DirectorExecutive Director Jan 12, 2020
Operational/Managerial ControlHealthcare Administrator Jan 12, 2020
Adp of the SNF Jan 12, 2020
Nelson Doyle Individual Corporate Director Oct 1, 2021
Lana Smolitsky Individual Corporate DirectorCfo Feb 1, 2025
Adp of the SNF Feb 1, 2025
Bryan F King Individual Corporate Director Oct 1, 2021
Lucille Kutz Individual Corporate Director Oct 1, 2020
Robert Piel Individual Corporate DirectorDirector Jun 11, 2011
Barbara McLaren Individual Corporate Director Oct 1, 2021
Steven Giuffre Individual Corporate DirectorDirector Jun 11, 2011
Joseph Pierpolli Individual Corporate Director Oct 1, 2021
Mary Sepowitz Individual Corporate Director Oct 1, 2021
Odd Fellows Healthcare Organization, Groton, CT Non-profit Operational/Managerial Control May 2, 2008
Vincent Barucci Individual Corporate Director Oct 1, 2019
Edith Kalin Individual Corporate DirectorDirector Jun 11, 2011
Millis Buckley Individual Corporate Director Oct 1, 2021

Owners & managing parties with NPI records 1

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1503878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1609393909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 LESTERTOWN RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063402808",
            "telephone_number": "860-445-7478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 LESTERTOWN RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063402808",
            "telephone_number": "860-445-7478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 Wilcox Rd Ste 107G",
            "address_purpose": "LOCATION",
            "city": "Stonington",
            "state": "CT",
            "postal_code": "063782614",
            "country_code": "US",
            "telephone_number": "860-445-7478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ODD FELLOWS HOME OF CONNECTICUT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ODD FELLOWS HOME OF CONNECTICUT, INC.",
        "enumeration_date": "2017-08-28",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ROSENMAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "860-445-7478"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairview",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FairviewFirst",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Groton, CT

Sources for this page

Verify at the official NPI Registry.