Kingston of Miamisburg, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1613N Issued in OH

Legal business name

KINGSTON OF MIAMISBURG, LLC

Practice address

1120 Dunaway St
Miamisburg, OH 45342-3839

Phone

(937) 866-9089

Fax

(937) 866-6907

NPI assigned

Oct 3, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Larry Nirschl

Title

Treasurer

Phone

(419) 247-2824

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Kingston Of Miamisburg Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Skilled nursing facility certification: CCN 365984

Legal name

KINGSTON OF MIAMISBURG, LLC

Doing business as

KINGSTON OF MIAMISBURG

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Mar 13, 1995

Last certification

Oct 19, 2023

Beds

113

Ownership / control type

Corporation

Multi-facility organization

Trilogy Health Services

Organization structure

LLCProprietary

Incorporated

Dec 31, 2005 in OH

Enrollment address

1120 Dunaway St
Miamisburg, OH 45342-3839

Nursing home name

KINGSTON OF MIAMISBURG

Affiliated entity

KINGSTON HEALTHCARE

Listed as

Kingston of MiamisburgCCN 365984

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

2 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Mar 13, 1995

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

11388.3 residents per day on average

Chain

Kingston Healthcare3 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Locations

All disclosed owners & managing parties 16

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

Facilities with the same owner 3

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

• Kingston Care Center of Sylvania, LLC

  • Skilled Nursing Facility
  • Sylvania, OH
  • NPI 1477540649

  Kingston Healthcare Company LLC, Kingston Healthcare Inc

  CMS ownership
• Kingston of Ashland, LLC

  • Skilled Nursing Facility
  • Ashland, OH
  • NPI 1659368884

  Kingston Healthcare Company LLC, Kingston Healthcare Inc

  CMS ownership
• Kingston of Vermilion, LLC

  • Skilled Nursing Facility
  • Vermilion, OH
  • NPI 1356338594

  Kingston Healthcare Company LLC, Kingston Healthcare Inc

  CMS ownership

Practitioners 3

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

• Mark S Jeffries, DO

  • Family Medicine Physician
  • Centerville, OH
  • NPI 1568458040
  NPD (past)
• Cherish Joy Prutzman, M.D

  • Internal Medicine Physician
  • Centerville, OH
  • NPI 1811907603
  NPD (past)
• Christine B Weller, DO, CMD

  • Family Medicine Physician
  • Bellbrook, OH
  • NPI 1811953318
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972590115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2165",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436032165",
            "telephone_number": "419-247-2880",
            "fax_number": "419-247-2872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 DUNAWAY ST",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423839",
            "telephone_number": "937-866-9089",
            "fax_number": "937-866-6907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSTON OF MIAMISBURG, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NIRSCHL",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "419-247-2824",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "1613N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000003059",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2611212",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kingston Of Miamisburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Seth T Kidwell, MSN, FNP-BC
• Sandra L Kimball, CNP
• Andrea Marie Kimmel
• Amy Marie King
• Maurine Muthoni Kingori
• Linda Lou Kintz, MD
• Audrey Kinzig, RBT
• Kyle Kirby, PA-C
• Micheal L Kitzmiller
• Patricia Klay, M.S.ED, LPCC

• Skilled Nursing Facility in Miamisburg, OH
• Providers in Miamisburg, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.

Verify at the official NPI Registry.