Active NPI
Carroll Healthcare Center Inc
- Nursing Facility/Intermediate Care Facility
- Carroliton, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- License
- 5021
- Legal business name
- CARROLL HEALTHCARE CENTER INC
- Practice address
- 648 Longhorn Street NW
Carroliton, OH 44615-9471 - Phone
- (330) 627-5501
- Fax
- (330) 627-3649
- NPI assigned
- Dec 19, 2005
- Last updated
- Aug 20, 2019
- 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
- Mr. Stacey Allen Howell
- Title
- Nha
- Phone
- (330) 965-9200
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 5021 | OH | Primary |
Addresses
Primary practice location
648 Longhorn Street NW
Carroliton, OH 44615-9471
Mailing address
648 Longhorn St NW
Carrollton, OH 44615-9469
Phone (330) 627-5501
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0430028 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071119000228 | OH | Part A Provider - Skilled Nursing Facility | 2860580222 | Practice locations: Carrollton, OH |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1861478174. Details of each certification follow.
Skilled nursing facility certification: CCN 365579
- Legal name
- CARROLL HEALTHCARE CENTER INC
- Doing business as
- CARROLL HEALTH CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Mar 11, 1982
- Last certification
- May 8, 2025
- Beds
- 52
- Ownership / control type
- Corporation
- Multi-facility organization
- inspira health group
- Organization structure
- Corporation
- Incorporated
- May 23, 1978 in OH
- Enrollment address
- 648 Longhorn St NW
Carrollton, OH 44615-9469 - Nursing home name
- CARROLL HEALTHCARE CENTER INC
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Carroll Healthcare Center Inc
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Mar 11, 1982
- Medicare certification status
- Active
- Certified beds
- 52
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D0342667 | Carroll Healthcare Center Inc | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 23
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 |
|---|---|---|---|
| Adp of the SNF | Aug 5, 2024 | ||
| JCTH Holdings, Inc. | Operational/Managerial Control | Sep 10, 2007 | |
| Adp of the SNF | Nov 16, 2020 | ||
| Adp of the SNF | Apr 16, 2018 | ||
| Michael T Huber | 5% Or Greater Direct Ownership Interest | Dec 21, 2018 | 25% |
| Corporate Director | Dec 21, 2018 | ||
| Managing Control - Governing Body | Dec 21, 2018 | ||
| Adp of the SNF | Dec 21, 2018 | ||
| Wesbanco Bank, Inc. | 5% Or Greater Mortgage Interest | Nov 4, 2015 | 50% |
| Adp of the SNF | Apr 1, 1995 | ||
| Adp of the SNF | Apr 15, 2025 | ||
| Adp of the SNF | Oct 12, 2015 | ||
| Adp of the SNF | Jan 31, 2017 | ||
| Nicholas Berardino | 5% Or Greater Direct Ownership Interest | Dec 21, 2018 | 25% |
| Corporate Officer | Dec 21, 2018 | ||
| Operational/Managerial Control | Dec 21, 2018 | ||
| Managing Control - Governing Body | Dec 21, 2018 | ||
| Adp of the SNF | Dec 21, 2018 | ||
| Adp of the SNF | May 5, 1996 | ||
| Brian McClain | Operational/Managerial Control | Jan 22, 2019 | |
| Adp of the SNF | Apr 9, 2025 | ||
| Adp of the SNF | Feb 1, 2007 | ||
| Larry Petrozzi | 5% Or Greater Direct Ownership Interest | Dec 21, 2018 | 25% |
| Corporate Director | Dec 21, 2018 | ||
| Managing Control - Governing Body | Dec 21, 2018 | ||
| Adp of the SNF | Dec 21, 2018 | ||
| Adp of the SNF | May 1, 1995 | ||
| Adp of the SNF | Oct 25, 2002 | ||
| Adp of the SNF | Oct 24, 2017 | ||
| Joseph Cilone | 5% Or Greater Direct Ownership Interest | Dec 21, 2018 | 25% |
| Corporate Officer | Jan 1, 2014 | 20% | |
| Corporate Director | Jan 1, 2014 | 100% | |
| Operational/Managerial Control | Jan 1, 2014 | ||
| Managing Control - Governing Body | Jan 1, 2014 | ||
| Adp of the SNF | Dec 21, 2018 | ||
| Nicole Jones | Operational/Managerial Control | Oct 8, 2018 | |
| Adp of the SNF | Nov 2, 1982 | ||
| Adp of the SNF | Apr 1, 2020 | ||
| Kaitlyn Mangan | Operational/Managerial Control | Mar 27, 2018 | |
| Adp of the SNF | Mar 27, 2018 | ||
| Adp of the SNF | May 24, 2004 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Canton, OH
- NPI 1821038043
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 3
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Caprice Health Care Center
- Skilled Nursing Facility
- North Lima, OH
- NPI 1124023585
JCTH Holdings, Inc.
-
- Skilled Nursing Facility
- Twinsburg, OH
- NPI 1396215976
JCTH Holdings, Inc.
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.
-
- Internal Medicine Physician
- Canton, OH
- NPI 1841442803
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134950400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1566259200000",
"number": "1861478174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "648 LONGHORN ST NW",
"city": "CARROLLTON",
"state": "OH",
"postal_code": "446159469",
"telephone_number": "330-627-5501",
"fax_number": "330-627-3649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "648 LONGHORN STREET NW",
"city": "CARROLITON",
"state": "OH",
"postal_code": "446159471",
"telephone_number": "330-627-5501",
"fax_number": "330-627-3649"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CARROLL HEALTHCARE CENTER INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-12-19",
"last_updated": "2019-08-20",
"status": "A",
"authorized_official_last_name": "HOWELL",
"authorized_official_first_name": "STACEY",
"authorized_official_middle_name": "ALLEN",
"authorized_official_title_or_position": "NHA",
"authorized_official_telephone_number": "330-965-9200",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "OH",
"license": "5021",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0430028",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; 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.