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Organization Active NPI

Miami Valley Hospital

  • Psychiatric Hospital Unit
  • Dayton, OH
National Provider Identifier
1003986423
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
MIAMI VALLEY HOSPITAL
Practice address
1 Wyoming St
Dayton, OH 45409-2722
Phone
(937) 208-8000
Fax
(937) 499-7813
NPI assigned
Nov 9, 2006
Organization subpart
Yes
Parent organization
MIAMI VALLEY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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

Authorized official

Name
Mr. Scott A. Shelton
Title
VP Finance
Phone
(937) 208-2530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X Primary

Addresses

Primary practice location

1 Wyoming St
Dayton, OH 45409-2722

Mailing address

1 Wyoming St
Dayton, OH 45409-2722
Phone (937) 208-8000

Other identifiers 1

IdentifierTypeStateIssuer
5935608MedicaidOH

Other names 1

  • Miami Valley Hospital - Psych Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071129000562 OH Part A Provider - Hospital 3274440987 Practice locations: Dayton, OH

Hospital certification: CCN 36S051

Legal name
MIAMI VALLEY HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Oct 20, 1890 in OH
Enrollment address
1 Wyoming St
Dayton, OH 45409-2722
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Compunet Miami Valley H8 organizations share this tax ID, including this one
Part of
Compunet Miami Valley H

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Chad T Whelan Individual Corporate OfficerSystem Coo & Pres. MVH Aug 7, 2023
Corporate DirectorBoard Member Aug 7, 2023
Jennifer Goins Individual W-2 Managing EmployeeDirector Reimbursement & Chargemstr Jan 1, 2022
Michael C Riordan Individual Corporate OfficerPresident & Ceo Feb 1, 2022
Corporate DirectorBoard Member Feb 1, 2022
Cara Powers Individual Corporate OfficerChief Legal Officer Oct 1, 2023
W-2 Managing EmployeeChief Legal Officer Oct 1, 2023
Craig Ganger Individual Corporate OfficerSystem VP/Chief Financial Officer Jan 4, 2021
Corporate DirectorCorporate Treasurer Jan 4, 2021
W-2 Managing EmployeeSystem VP/Chief Financial Officer Jan 4, 2021
Andre T Harris Individual Corporate DirectorBoard Member Jan 1, 2025
Miami Valley Hospital Organization, Dayton, OH Non-profit Operational/Managerial Control Jan 1, 2007
Premier Health Partners Organization, Dayton, OH Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2018 100%
Operational/Managerial Control Jul 14, 1995
Amulya C Belagavi Individual Corporate DirectorBoard Member Jan 1, 2024
Stacey Lawson Individual Corporate DirectorBoard Member Jan 1, 2021
Laura E Gottron Individual Corporate DirectorBoard Member Jan 1, 2025

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 6

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

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482105600000",
    "number": "1003986423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WYOMING ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092722",
            "telephone_number": "937-208-8000",
            "fax_number": "937-499-7813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WYOMING ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092722",
            "telephone_number": "937-208-8000",
            "fax_number": "937-499-7813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIAMI VALLEY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIAMI VALLEY HOSPITAL",
        "enumeration_date": "2006-11-09",
        "last_updated": "2016-12-19",
        "status": "A",
        "authorized_official_last_name": "SHELTON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "937-208-2530",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5935608",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miami Valley Hospital - Psych",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.