EDGEWOOD MANOR OF LUCASVILLE II LLC (NPI# 1609394535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609394535 |
| Entity Type | Organization |
| Organization Name | EDGEWOOD MANOR OF LUCASVILLE II LLC |
| Practice Address |
10098a Big Bear Creek Rd Lucasville OH 45648-9168 |
| Mailing Address |
1535 Rockaway Pkwy Brooklyn NY 11236-4001 |
| Practice Telephone | 7402592531 |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2017-08-30 |
| Authorized Official Name | ALEXANDER SHERMAN (MANAGING MEMBER) |
| Authorized Official Telephone | 7186888760 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | ODH HOME NUMBER | 0685N | 01 |
| Street Address |
10098A BIG BEAR CREEK RD |
| City | LUCASVILLE |
| State | OH |
| Zip Code | 45648-9168 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396115267 | Jennifer Sommer | Occupational Therapist | 10098a Big Bear Creek Rd, Lucasville, OH 45648-9168 | 2015-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558762138 | Cobra Pharmacy, LLC | Pharmacy | 37 C Lucasville-minford Road, Lucasville, OH 45648 | 2014-09-15 |
| 1366842221 | Premier Therapy & Health Centers, Inc. | Clinic/Center | 10606 U.S. 23, Lucasville, OH 45648 | 2014-08-28 |
| 1720495260 | Stephanie Jordan | Contractor | 9500 Campcreek Rd, Lucasville, OH 45648 | 2014-07-16 |
| 1851630255 | Amy D Reeder | Occupational Therapy Assistant | 10098a Big Bearcreek, Lucasville, OH 45648 | 2013-02-05 |
| 1033458567 | Christopher E Holbrook Sr. | Durable Medical Equipment & Medical Supplies | 10324 Us Rte 23, Lucasville, OH 45648 | 2013-02-04 |
| 1366735953 | Health Maintenance Partners, Inc. | Clinic/Center | 10701 Us 23 South, Lucasville, OH 45648 | 2011-05-16 |
| 1154552271 | Dianne N Bragdon | Licensed Practical Nurse | 115 Borders Road, Lucasville, OH 45648 | 2009-08-06 |
| 1134368459 | Friends of Good Shepherd Manor | Intermediate Care Facility, Mentally Retarded | 374 Good Manor Rd, Lucasville, OH 45648 | 2009-02-10 |
| 1366688897 | Scioto Ambulance District | Ambulance | 7106 Big Bear Creek Road, Lucasville, OH 45648 | 2009-01-06 |
| 1831311422 | Cheryl Annette Frazier | Licensed Practical Nurse | 763 Dewey Ext, Lucasville, OH 45648 | 2007-05-03 |
| Find all providers in zip 45648 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972530392 | Tandem Health Care of Lucasville I, Inc. | Skilled Nursing Facility | 10098 Big Bear Creek Road, Lucasville, OH 45648-0789 | 2006-06-28 |
| 1790721983 | Tandem Health Care of Lucasville II, Inc. | Skilled Nursing Facility | 10098a Big Bear Creek Road, Lucasville, OH 45648-0789 | 2006-06-22 |
| 1083132914 | Edgewood Manor of Lucasville I LLC | Skilled Nursing Facility | 10098 Big Bear Creek Rd, Lucasville, OH 45648-9168 | 2017-08-30 |
| 1861853152 | Genesis Rehab Services | Skilled Nursing Facility | 10098 Big Bear Creek Rd, Lucasville, OH 45648-9168 | 2016-03-14 |
| 1073527800 | Lucasville II Facility Operations, LLC | Skilled Nursing Facility | 10098a Big Bear Creek Road, Lucasville, OH 45648-0789 | 2006-07-28 |
| 1730103813 | Lucasville I Facility Operations, LLC | Skilled Nursing Facility | 10098 Big Bear Creek Road, Lucasville, OH 45648-0789 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629694229 | The Laurels of West Columbus, LLC | Skilled Nursing Facility | 441 Norton Rd, Columbus, OH 43228 | 2020-06-19 |
| 1508492174 | Majestic Care of Paulding LLC | Skilled Nursing Facility | 199 Road 103, Paulding, OH 45879-8776 | 2020-03-16 |
| 1548890338 | Trilogy Healthcare of Gahanna, LLC | Skilled Nursing Facility | 748 Taylor Rd, Gahanna, OH 43230-3203 | 2020-01-21 |
| 1396384194 | Progressive North Ridgeville LLC | Skilled Nursing Facility | 6200 Lear Nagle Rd, North Ridgeville, OH 44039-3224 | 2019-12-27 |
| 1154962835 | Sycamorespring Health Care and Rehabilitation LLC | Skilled Nursing Facility | 2175 Leiter Rd, Miamisburg, OH 45342-3659 | 2019-10-03 |
| 1255980876 | Ehcs Oakhill Properties, LLC | Skilled Nursing Facility | 4466 Lynnhaven Ave, Louisville, OH 44641-9513 | 2019-09-06 |
| 1083260988 | Trilogy Healthcare of Tiffin, LLC | Skilled Nursing Facility | 410 Fair Lane, Tiffin, OH 44883 | 2019-08-15 |
| 1427604321 | Trilogy Healthcare of Pickerington, LLC | Skilled Nursing Facility | 603 Diley Road, Pickerington, OH 43147 | 2019-08-15 |
| 1205482189 | Trilogy Healthcare of Franklin IIi, LLC | Skilled Nursing Facility | 7320 Smith's Mill Road, New Albany, OH 43054 | 2019-08-15 |
| 1972164713 | Cardinal Delaware, Inc. | Skilled Nursing Facility | 6975 Graphics Way, Lewis Center, OH 43035 | 2019-06-24 |
| Find all providers with the same taxonomy | ||||
| City | LUCASVILLE |
| Zip Code | 45648 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.