NPIMap

Organization Active NPI

State of Ohio Office of Budget and Management State Accounting

Doing business as Appalachian Behavioral Healthcare, Athens Campus

  • Psychiatric Hospital
  • Athens, OH
National Provider Identifier
1063486058
Registry record updated Oct 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
NA Issued in NU
Legal business name
STATE OF OHIO OFFICE OF BUDGET AND MANAGEMENT STATE ACCOUNTING
Doing business as
Appalachian Behavioral Healthcare, Athens Campus
Practice address
100 Hospital Dr
Athens, OH 45701-2301
Phone
(614) 594-5000
Fax
(740) 594-3006
NPI assigned
Feb 15, 2006
Last updated
Oct 6, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2010

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

Authorized official

Name
Ms. Jane Krason
Title
Ceo
Phone
(740) 594-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X NA NU Primary

Addresses

Primary practice location

100 Hospital Dr
Athens, OH 45701-2301

Mailing address

30 E Broad St
11TH FL, Attn:Tonya Fasone
Columbus, OH 43215-3414
Phone (614) 466-9930

Other identifiers 1

IdentifierTypeStateIssuer
0150303MedicaidOH

Other names 1

  • Appalachian Behavioral Healthcare, Athens Campus Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031202000209 OH Part B Supplier - Clinic/Group Practice 0143133181 Receives reassigned benefits from 261 practitioners
28 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Northfield, OH; Youngstown, OH; Toledo, OH; Tiffin, OH; Mt Vernon, OH; Mineral Ridge, OH; Massillon, OH; Huber Heights, OH…
O20061121000048 OH Part A Provider - Hospital 0143133181 Practice locations: Athens, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063486058. Details of each certification follow.

Hospital certification: CCN 364015

Legal name
STATE OF OHIO OFFICE OF BUDGET AND MANAGEMENT STATE ACCOUNTING
Doing business as
APPALACHIAN BEHAVIORAL HEALTH CARE
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Feb 20, 1967
Last certification
Apr 29, 2008
Beds
40
Ownership / control type
Private (for profit)
Organization structure
GovernmentNon-profit
Incorporated
in OH
Enrollment address
100 Hospital Dr
Athens, OH 45701-2301
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric, Specialty hospital

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 26

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

View all 26

Care Compare: Hospital

Medicare Care Compare
Listed as
Appalachian Behavioral Health CareCCN 364015 · All quality measures
Type
Psychiatric
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D1073270Appalachian Behavioral Healthcare100 Hospital Drive, Athens, OH 45701Certificate of waiverSep 4, 2027

National Provider Directory

National Provider Directory
Tax ID family
Central Ohio Pyschiatri39 organizations share this tax ID, including this one

Other organizations with this tax ID 38

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

View all 38

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
State of Ohio Office of Budget and Management State Accounting Organization, Columbus, OH Operational/Managerial Control Jan 1, 1993 100%
Joshua Sargent Individual Operational/Managerial ControlFinancial Analyst Supervisor Sep 26, 2025
Scott Geib Individual Operational/Managerial ControlRevenue Manager Sep 26, 2025
Jackie Davis Individual Operational/Managerial ControlSenior Financial Analyst Sep 26, 2025

Owners & managing parties with NPI records 7

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

All facility ownership & control disclosures 7

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

FacilityTypeRoleSince
Central Ohio Behavioral HealthcareColumbus, OH, CCN 364007 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1993
Northcoast Behavioral Healthcare Northfield CampusNorthfield, OH, CCN 364011 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 1993
Jan 1, 1993
Northwest Ohio Behavioral HealthcareToledo, OH, CCN 364014 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1993
Heartland Behavioral HealthcareMassillon, OH, CCN 364031 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 1993
Jan 1, 1993
Summit Behavioral HealthcareCincinnati, OH, CCN 364035 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 1993
Jan 1, 1993
Ohio Veterans Home - GeorgetownGeorgetown, OH, CCN 366351 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF
Direct Ownership Interest (100%)		 Nov 15, 2003
Nov 15, 2003
Nov 15, 2003
Ohio Veterans Home AgencySandusky, OH, CCN 366325 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF
Direct Ownership Interest (100%)		 Jan 1, 1996
Feb 28, 2003
Feb 28, 2003

Owned or controlled facilities with NPI records 7

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

Facilities with the same owner 7

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

Practitioners & affiliated clinicians

Practitioners 29

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.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286323200000",
    "number": "1063486058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E BROAD ST",
            "address_2": "11TH FL, ATTN:TONYA FASONE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432153414",
            "telephone_number": "614-466-9930",
            "fax_number": "614-644-9116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457012301",
            "telephone_number": "614-594-5000",
            "fax_number": "740-594-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF OHIO OFFICE OF BUDGET AND MANAGEMENT STATE ACCOUNTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-15",
        "last_updated": "2010-10-06",
        "status": "A",
        "authorized_official_last_name": "KRASON",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "740-594-5000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "NU",
            "license": "NA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0150303",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Appalachian Behavioral Healthcare, Athens Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Athens, OH

Sources for this page

Verify at the official NPI Registry.