Crestmont North Nursing Home – Nursing Facility/Intermediate Care Facility, NPI 1487656773

Crestmont North Nursing Home is a healthcare provider. based in Lakewood, Ohio. specializing in Nursing Facility/Intermediate Care Facility. The organization holds a License No. 4284 (OH). The NPI Number for Crestmont North Nursing Home is 1487656773

Main info

Organization
Name
Crestmont North Nursing Home
NPI
1487656773
Phone
(216) 539-7846
Address
13330 DETROIT AVE
Authorized Official
MR. ELIAS J COURY OWNER
Enumeration Date
1 June 2005
Last Update Date
3 October 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness80
Years active:21State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Crestmont North Nursing Home

  • 13330 DETROIT AVE

    LAKEWOOD, OH 441072850

    Phone: (216) 539-7846

    Fax: (216) 521-1212

    Type: Mailing

  • Detroit Avenue, Edgewater, Lakewood, Cuyahoga County, Ohio, 44102:44111, United States

    LAKEWOOD, OH 441072850

    Phone: (216) 228-9550

    Fax: (216) 521-2193

    Type: Location

  • Sperry Drive, Westlake, Cuyahoga County, Ohio, 44145-2579, United States

    WESTLAKE, OH 441451565

    Phone: (440) 617-2103

    Fax: (440) 835-2029

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-06-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20080609000895OSkilled Nursing FacilityOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44107)

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Reviews

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Frequently asked questions

Is there an official ID for Crestmont North Nursing Home in U.S. healthcare records?
The official identifier for Crestmont North Nursing Home is NPI 1487656773.
Active or inactive — what applies to Crestmont North Nursing Home?
You should see Crestmont North Nursing Home as active in CMS-hosted NPPES data.
What expertise is attributed to Crestmont North Nursing Home?
Crestmont North Nursing Home's specialty line reads Nursing Facility/Intermediate Care Facility. Clinical services aligned with this taxonomy classification.
Where in Ohio is Crestmont North Nursing Home registered?
Use Lakewood, Ohio as the headline location for Crestmont North Nursing Home here.
When was this NPI issued?
Enumeration for Crestmont North Nursing Home is noted as June 1, 2005 where the registry provides it.

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