NPIMap

Organization Active NPI

Jag Healthcare Mansfield LLC

Doing business as Jag Mansfield

  • Skilled Nursing Facility
  • Mansfield, OH
National Provider Identifier
1902624463
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
JAG HEALTHCARE MANSFIELD LLC
Doing business as
Jag Mansfield
Practice address
50 Blymyer Ave
Mansfield, OH 44903-2343
Phone
(440) 667-7800
NPI assigned
Oct 2, 2024
Last updated
Oct 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Authorized official

Name
Adel Krumins
Title
Account Manager
Phone
(440) 667-7800

Specialties & licenses 1

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

Addresses

Primary practice location

50 Blymyer Ave
Mansfield, OH 44903-2343

Mailing address

2226 Wooster Rd
Rocky River, OH 44116-2749
Phone (440) 667-7800

Other names 1

  • Jag Mansfield Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250610003964 OH Part A Provider - Skilled Nursing Facility 7012427818 Practice locations: Mansfield, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902624463. Details of each certification follow.

Skilled nursing facility certification: CCN 365118

Legal name
JAG HEALTHCARE MANSFIELD LLC
Doing business as
JAG HEALTHCARE MANSFIELD
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 4, 1967
Last certification
Aug 18, 2022
Beds
66
Ownership / control type
Corporation
Multi-facility organization
JAG Healthcare
Organization structure
LLCProprietary
Enrollment address
50 Blymyer Ave
Mansfield, OH 44903-2343
Nursing home name
JAG HEALTHCARE MANSFIELD
Affiliated entity
JAG HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Jag Healthcare MansfieldCCN 365118 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 4, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6660.6 residents per day on average
Chain
Jag Healthcare9 facilities in the chain
Penalties (3 years)
2Fines totaling $130,240

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
36D0344521Jag Healthcare Mansfield50 Blymyer Avenue, Mansfield, OH 44903Certificate of waiverAug 31, 2026

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
Mansfield Memorial Homes, Inc Organization, Rocky River, OH Corporation Operational/Managerial Control Nov 1, 2024
Adp of the SNF Nov 1, 2024
David Cooley Individual 5% Or Greater Direct Ownership Interest Nov 1, 2024 33.3%
Operational/Managerial Control Nov 1, 2024
Managing Control - Governing BodyCfo Nov 1, 2024
Adp of the SNF Nov 1, 2024
Martin Tremmel Individual Adp of the SNF Jun 11, 2025
Zallaca Romero Individual Operational/Managerial Control Nov 1, 2024
Adp of the SNF Nov 1, 2024
Jag Healthcare Inc Organization, Rocky River, OH Corporation Operational/Managerial Control Nov 1, 2024
Adp of the SNF Nov 1, 2024
Ajay Chawla Individual Operational/Managerial Control Nov 1, 2024
Adp of the SNF Nov 1, 2024
James Griffiths Individual 5% Or Greater Direct Ownership Interest Nov 1, 2024 66.6%
Operational/Managerial Control Nov 1, 2024
Managing Control - Governing BodyCeo Nov 1, 2024
Adp of the SNF Nov 1, 2024

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 8

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

Practitioners & affiliated clinicians

Practitioners 3

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 3

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": "1727827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727827200000",
    "number": "1902624463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2226 WOOSTER RD",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441162749",
            "telephone_number": "440-667-7800",
            "fax_number": "440-356-0754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BLYMYER AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449032343",
            "telephone_number": "440-667-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAG HEALTHCARE MANSFIELD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A",
        "authorized_official_last_name": "KRUMINS",
        "authorized_official_first_name": "ADEL",
        "authorized_official_title_or_position": "ACCOUNT MANAGER",
        "authorized_official_telephone_number": "440-667-7800"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jag Mansfield",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mansfield, OH

Sources for this page

Verify at the official NPI Registry.