NPIMap

Organization Active NPI

Otterbein Loveland, LLC

  • Skilled Nursing Facility
  • Loveland, OH
National Provider Identifier
1780042622
Registry record updated Nov 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
OTTERBEIN LOVELAND, LLC
Practice address
6405 Small House Cir
Loveland, OH 45140-7524
Phone
(513) 933-5401
NPI assigned
Feb 7, 2016
Last updated
Nov 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2016

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

Authorized official

Name
James Chris Green, CPA
Title
Treasurer & Chief Financial Officer
Phone
(513) 933-5418

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

6405 Small House Cir
Loveland, OH 45140-7524

Mailing address

580 N State Route 741
Lebanon, OH 45036-8839
Phone (513) 933-5401

Other identifiers 1

IdentifierTypeStateIssuer
0160396MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160406000026 OH Part A Provider - Skilled Nursing Facility 6406154517 Practice locations: Loveland, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780042622. Details of each certification follow.

Skilled nursing facility certification: CCN 366445

Legal name
OTTERBEIN LOVELAND LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 15, 2016
Last certification
May 1, 2023
Beds
60
Ownership / control type
Church Related
Multi-facility organization
Otterbein SeniorLife
Organization structure
LLCNon-profit
Incorporated
May 3, 2013 in OH
Enrollment address
6405 Small House Cir
Loveland, OH 45140-7524
Nursing home name
OTTERBEIN LOVELAND
Affiliated entity
OTTERBEIN SENIORLIFE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Otterbein LovelandCCN 366445 · All quality measures
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Church related
Certified
Aug 15, 2016
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6060.7 residents per day on average
Chain
Otterbein Seniorlife20 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2113127Otterbein Loveland6405 Small House Circle, Loveland, OH 45140Certificate of waiverMay 16, 2028

National Provider Directory

National Provider Directory

Locations

3855 Lower Market St
Ste 300
Lebanon, OH 45036

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Becky Bayliff Individual Operational/Managerial Control Dec 1, 2021
Polaris Pharmacy Services of Ohio LLC Organization, Columbus, OH LLC, Medical provider/supplier, Consulting firm, For-profit Adp of the SNF Dec 1, 2018
Heidi Glosser Individual Operational/Managerial Control Dec 1, 2021
Victoria Bartlett Individual Operational/Managerial Control Dec 1, 2021
Vijayalakshmi Chinta Individual Adp of the SNF Dec 1, 2021
William Brownson Individual Operational/Managerial Control Dec 1, 2021
Rita C Hawkins Individual Operational/Managerial ControlAsst VP of Finance & Controller Aug 17, 2015
Tomas Hazelbaker Individual Operational/Managerial Control Dec 1, 2021
Ralph Reed Fraley Individual Operational/Managerial Control Dec 1, 2021
Functional Pathways of Tennessee LLC Organization, Knoxville, TN LLC, Medical provider/supplier, Medical staffing company, For-profit Operational/Managerial Control Dec 1, 2018
Adp of the SNF Apr 4, 2025
Otterbein Neighborhoods, LLC Organization, Lebanon, OH LLC, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 1, 2016 100%
Jill Wilson Individual Corporate OfficerPresident & Ceo May 1, 2009
Otterbein Home Organization, Lebanon, OH Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Dec 1, 2021 100%
Operational/Managerial Control Dec 1, 2021
Adp of the SNF Dec 1, 2021
Madeline Damico Individual Operational/Managerial Control May 6, 2019
Adp of the SNF May 6, 2019
Daniel Arnold Individual Corporate OfficerVP Small Houses Sep 3, 2018
James Christopher Green Individual Corporate OfficerCfo Nov 21, 2005
Operational/Managerial Control Dec 1, 2021
Robert Coleman Individual Operational/Managerial Control Dec 1, 2021
Daniel Burke Individual Operational/Managerial Control Dec 1, 2021
Lynn App Individual Operational/Managerial Control Dec 1, 2021
Steve Vonderhaar Individual Operational/Managerial Control Dec 1, 2021

Owners & managing parties with NPI records 2

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

Facilities with the same owner 27

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

View all 27

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": "1454803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478476800000",
    "number": "1780042622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 N STATE ROUTE 741",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450368839",
            "telephone_number": "513-933-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 SMALL HOUSE CIR",
            "city": "LOVELAND",
            "state": "OH",
            "postal_code": "451407524",
            "telephone_number": "513-933-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTTERBEIN LOVELAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-07",
        "last_updated": "2016-11-07",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "CHRIS",
        "authorized_official_title_or_position": "TREASURER & CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "513-933-5418",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0160396",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, OH

Sources for this page

Verify at the official NPI Registry.