Active NPI
Magnolia Village Health Center LLC
- Alzheimer Center (Dementia Center)
- Bowling Green, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Alzheimer Center (Dementia Center)
- Legal business name
- MAGNOLIA VILLAGE HEALTH CENTER LLC
- Practice address
- 1381 Campbell Lane
Bowling Green, KY 42104 - Phone
- (270) 843-0587
- NPI assigned
- Nov 2, 2022
- 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
- Mayer Fischl
- Title
- Owner/Managing Member
- Phone
- (718) 757-6399
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Alzheimer Center (Dementia Center) | 311500000X | Primary | ||
| Skilled Nursing Facility | 314000000X |
Addresses
Primary practice location
1381 Campbell Lane
Bowling Green, KY 42104
Mailing address
300 Provider Court
Richmond, KY 40475
Other names 1
- Magnolia Village
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240409001846 | KY | Part A Provider - Skilled Nursing Facility | 4587002654 | Practice locations: Bowling Green, KY |
Skilled nursing facility certification: CCN 185435
- Legal name
- MAGNOLIA VILLAGE HEALTH CENTER LLC
- Doing business as
- MAGNOLIA VILLAGE NURSING & REHABILITATION CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 19, 1997
- Last certification
- Jun 26, 2025
- Beds
- 60
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Encore Health Partners
- Organization structure
- LLC
- Enrollment address
- 1381 Campbell LN
Bowling Green, KY 42104-1049 - Nursing home name
- MAGNOLIA VILLAGE NURSING AND REHABILITATION CENTER
- Affiliated entity
- ENCORE HEALTH PARTNERS
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Magnolia Village Nursing and Rehabilitation Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jun 19, 1997
- Medicare certification status
- Active
- Certified beds
- 60
- Chain
- Encore Health Partners
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 |
|---|---|---|---|
| 18D1060234 | Magnolia Health Center LLC | Certificate of waiver | Oct 17, 2026 |
National Provider Directory
National Provider DirectoryLocations
1381 Campbell Ln
Bowling Green, KY 42104
Phone (270) 843-0587
Ownership & 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 |
|---|---|---|---|
| Encore Investors LLC | 5% Or Greater Direct Ownership Interest | Feb 1, 2024 | 100% |
| Mayer Fischel | Corporate Officer | Feb 1, 2024 | 100% |
| Operational/Managerial Control | Feb 1, 2024 | 100% | |
| Encore Health Partners 2 LLC | Operational/Managerial Control | Feb 1, 2024 | 100% |
| Adp of the SNF | Mar 19, 2025 | ||
| Adp of the SNF | Feb 1, 2024 | ||
| Sarah Zoberman | Adp of the SNF | Feb 1, 2024 | |
| Indirect Ownership Interest | Feb 1, 2024 | 2.5% | |
| David Bloom | 5% Or Greater Indirect Ownership Interest | Feb 1, 2024 | 5% |
| Adp of the SNF | Feb 1, 2024 | ||
| Adp of the SNF | Mar 19, 2025 | ||
| Adp of the SNF | Feb 1, 2024 | ||
| Nirav Sheth | Adp of the SNF | Feb 1, 2024 | |
| Adp of the SNF | Jan 1, 2024 | ||
| Eli Grinspan | 5% Or Greater Indirect Ownership Interest | Feb 1, 2024 | 15% |
| Corporate Officer | Feb 1, 2024 | 100% | |
| Operational/Managerial Control | Feb 1, 2024 | 100% | |
| Adp of the SNF | Feb 1, 2024 | ||
| David Rubenstein | 5% Or Greater Indirect Ownership Interest | Feb 1, 2024 | 5% |
| Adp of the SNF | Feb 1, 2024 | ||
| Adp of the SNF | Feb 1, 2024 | ||
| Ashley Pruitt | Operational/Managerial Control | Apr 19, 2021 | |
| Adp of the SNF | Apr 19, 2021 | ||
| Encore Realty 2 LLC | Adp of the SNF | Feb 1, 2024 | |
| Adp of the SNF | Jan 1, 2024 | ||
| Keybank National Association | 5% Or Greater Mortgage Interest | Feb 1, 2024 | 100% |
| Isaac Grinspan | 5% Or Greater Indirect Ownership Interest | Feb 1, 2024 | 7.5% |
| Adp of the SNF | Feb 1, 2024 | ||
| Adp of the SNF | Feb 1, 2024 | ||
| 1381 Campbell Land Realty LLC | Adp of the SNF | Feb 1, 2024 | |
| Adp of the SNF | Feb 1, 2024 | ||
| Darla Waymon | Adp of the SNF | Feb 1, 2024 | |
| Adp of the SNF | Mar 19, 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 9
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Frankfort, KY
- NPI 1700593456
Encore Health Partners 2 LLC, Encore Investors LLC
-
- Skilled Nursing Facility
- Florence, KY
- NPI 1295442937
Encore Health Partners 2 LLC, Encore Investors LLC
-
- Skilled Nursing Facility
- Bowling Green, KY
- NPI 1578270203
Encore Health Partners 2 LLC, Encore Investors LLC
-
- Skilled Nursing Facility
- Burkesville, KY
- NPI 1962112854
Encore Health Partners 2 LLC
-
- Skilled Nursing Facility
- Brownsville, KY
- NPI 1881301539
Encore Health Partners 2 LLC, Encore Investors LLC
-
- Skilled Nursing Facility
- Lewisport, KY
- NPI 1013624741
Encore Health Partners 2 LLC, Encore Investors LLC
-
- Skilled Nursing Facility
- Madisonville, KY
- NPI 1376250019
Encore Health Partners 2 LLC, Encore Investors LLC
-
- Skilled Nursing Facility
- Woodburn, KY
- NPI 1265149900
Encore Health Partners 2 LLC
-
- Skilled Nursing Facility
- Elizabethtown, KY
- NPI 1790492437
Encore Health Partners 2 LLC
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Bowling Green, KY
- NPI 1134137144
-
- Internal Medicine Physician
- Bowling Green, KY
- NPI 1295178036
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": "1667347200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1667347200000",
"number": "1952018681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 PROVIDER COURT",
"city": "RICHMOND",
"state": "KY",
"postal_code": "40475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1381 CAMPBELL LANE",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "42104",
"telephone_number": "270-843-0587"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAGNOLIA VILLAGE HEALTH CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-11-02",
"last_updated": "2022-11-02",
"certification_date": "2022-11-02",
"status": "A",
"authorized_official_last_name": "FISCHL",
"authorized_official_first_name": "MAYER",
"authorized_official_title_or_position": "OWNER/MANAGING MEMBER",
"authorized_official_telephone_number": "718-757-6399"
},
"taxonomies": [
{
"code": "311500000X",
"taxonomy_group": "",
"desc": "Alzheimer Center (Dementia Center)",
"state": null,
"license": null,
"primary": true
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Magnolia Village",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Bowling Green, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; 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.