NPIMap

Organization Active NPI

FHS Fairlawn, Inc.

  • Skilled Nursing Facility
  • Fairlawn, OH
National Provider Identifier
1790311082
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
FHS FAIRLAWN, INC.
Practice address
3558 Ridgewood Rd
Fairlawn, OH 44333-3122
Phone
(330) 472-0296
NPI assigned
Mar 18, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Authorized official

Name
Sandy Muir
Title
VP of Government Affairs
Phone
(440) 793-2245

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3558 Ridgewood Rd
Fairlawn, OH 44333-3122

Mailing address

25000 Country Club Blvd Ste 255
North Olmsted, OH 44070-5337
Phone (440) 793-2245

Other identifiers 1

IdentifierTypeStateIssuer
0399228MedicaidOH

Other names 1

  • TIMBERLAND RIDGE NURSING & REHABILITATION Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200414003793 OH Part A Provider - Skilled Nursing Facility 0749610731 Practice locations: Fairlawn, OH

Skilled nursing facility certification: CCN 366479

Legal name
FHS FAIRLAWN INC
Doing business as
TIMBERLAND RIDGE NURSING & REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 24, 2020
Last certification
May 4, 2023
Beds
75
Ownership / control type
Corporation
Organization structure
CorporationProprietary
Incorporated
Jun 28, 2019 in OH
Enrollment address
3558 Ridgewood Rd
Fairlawn, OH 44333-3122
Nursing home name
TIMBERLAND RIDGE NURSING & REHABILITATION
Affiliated entity
FOUNDATIONS HEALTH SOLUTIONS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Timberland Ridge Nursing & RehabilitationCCN 366479
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jun 24, 2020
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7560.7 residents per day on average
Chain
Foundations Health Solutions64 facilities in the chain
Penalties (3 years)
1Fines totaling $0

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
36D2182769FHS Fairlawn, Inc3558 Ridgewood Rd, Fairlawn, OH 44333Certificate of waiverApr 26, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Charles Jackson Individual Operational/Managerial Control Apr 28, 2025
Adp of the SNF Apr 28, 2025
John Krystowski Individual Corporate OfficerTreasurer May 1, 2020
Operational/Managerial Control May 1, 2020
Adp of the SNF May 1, 2020
Brian E Colleran Individual Corporate OfficerPresident Jun 1, 2020
Corporate DirectorPresident Jun 1, 2020
Operational/Managerial Control Jun 1, 2020
Adp of the SNF Jun 1, 2020
Harikrishna Choudary Ponnam Individual Adp of the SNF May 1, 2020
Colleran Fam TR Dated 01-01-2018 Organization, North Olmsted, OH 5% Or Greater Indirect Ownership Interest May 1, 2020 100%
Foundations Health LLC Organization, North Olmsted, OH LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest May 1, 2020 100%
Foundations Health Solutions, LLC Organization, North Olmsted, OH LLC, Management services company, For-profit Operational/Managerial Control May 1, 2020
Adp of the SNF Jul 3, 2025

Owners & managing parties with NPI records 1

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

Facilities with the same owner 64

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

View all 64

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1584489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759363200000",
    "number": "1790311082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25000 COUNTRY CLUB BLVD STE 255",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440705337",
            "telephone_number": "440-793-2245",
            "fax_number": "440-614-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3558 RIDGEWOOD RD",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333122",
            "telephone_number": "330-472-0296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FHS FAIRLAWN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-18",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A",
        "authorized_official_last_name": "MUIR",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "VP OF GOVERNMENT AFFAIRS",
        "authorized_official_telephone_number": "440-793-2245"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0399228",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TIMBERLAND RIDGE NURSING & REHABILITATION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairlawn, OH

Sources for this page

Verify at the official NPI Registry.