NPIMap

Organization Active NPI

Country Drive Inn Medical Practice

  • Family Nurse Practitioner
  • Mount Perry, OH
National Provider Identifier
1003524430
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
COUNTRY DRIVE INN MEDICAL PRACTICE
Practice address
10825 Township Road 49
Mount Perry, OH 43760-9779
Phone
(740) 221-6550
NPI assigned
Nov 15, 2022
Last updated
Dec 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Authorized official

Name
Arica Reeves, APRNNPI 1891081998
Title
Owner/Provider
Phone
(740) 221-6550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

10825 Township Road 49
Mount Perry, OH 43760-9779

Mailing address

10825 Township Road 49
Mount Perry, OH 43760-9779
Phone (740) 221-6550

Other identifiers 1

IdentifierTypeStateIssuer
0053044MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address countrydriveinnmedpractice@qualitycarepartners.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230428002017 OH Part B Supplier - Clinic/Group Practice 8224493168 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Mount Perry, OH

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Country Drive Inn Medical Practice2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Country Drive Inn Medical PracticeMount Perry, OH, CCN 363881 Rural health clinic Operational/Managerial Control (100%) May 11, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

NPI Registry JSON

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765756800000",
    "number": "1003524430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10825 TOWNSHIP ROAD 49",
            "city": "MOUNT PERRY",
            "state": "OH",
            "postal_code": "437609779",
            "telephone_number": "740-221-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10825 TOWNSHIP ROAD 49",
            "city": "MOUNT PERRY",
            "state": "OH",
            "postal_code": "437609779",
            "telephone_number": "740-221-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY DRIVE INN MEDICAL PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-15",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A",
        "authorized_official_last_name": "REEVES",
        "authorized_official_first_name": "ARICA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "740-221-6550",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0053044",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "countrydriveinnmedpractice@qualitycarepartners.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10825 Township Road 49",
            "city": "Mount Perry",
            "state": "OH",
            "country_code": "US",
            "postal_code": "437609779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Perry, OH

Sources for this page

Verify at the official NPI Registry.