NPIMap

Organization Active NPI

Adams County Regional Medical Center

Doing business as Adams County Regional Medical Center (ACRMC) Family Medicine

  • Rural Health Clinic/Center
  • Peebles, OH
National Provider Identifier
1114640240
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ADAMS COUNTY REGIONAL MEDICAL CENTER
Doing business as
Adams County Regional Medical Center (ACRMC) Family Medicine
Practice address
154 Elliott Ave
Peebles, OH 45660-1028
Phone
(937) 587-2618
Fax
(937) 587-2288
NPI assigned
Sep 23, 2022
Last updated
Sep 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Authorized official

Name
Pete Dagenbach
Title
Cfo
Phone
(937) 386-3007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

154 Elliott Ave
Peebles, OH 45660-1028

Mailing address

230 Medical Center Dr
Seaman, OH 45679-8002
Phone (937) 386-3400

Other names 1

  • Adams County Regional Medical Center (ACRMC) Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230131002693 OH Part A Provider - Rural Health Clinic 8921431131 Practice locations: Peebles, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114640240. Details of each certification follow.

Rural health clinic certification: CCN 363439

Legal name
ADAMS COUNTY REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 14, 2023
Last certification
Jul 14, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 2019 in OH
Enrollment address
154 Elliott Ave
Peebles, OH 45660-1028
Related CCNs
361326

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

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Tax ID family
Adams County Regional Medical Center7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Pete R Dagenbach Individual Corporate OfficerCfo Oct 1, 2019
Matthew a Armstrong Individual Corporate DirectorBoard Member Oct 1, 2019
Radah Curtis Individual W-2 Managing EmployeeRevenue Cycle Manager Oct 1, 2019
Alan Bird Individual Corporate OfficerCeo Oct 1, 2019
Dane R Clark Individual Corporate DirectorBoard Member Oct 1, 2019
Peggy Chalker Individual Corporate DirectorBoard Member Oct 1, 2019
Jack a McCoy Individual Corporate DirectorBoard Member Oct 1, 2019
Sherri M Spencer Individual Corporate DirectorBoard Member Oct 1, 2019
Chad Wilson Individual Corporate DirectorBoard Member Oct 1, 2019
Roy Gustin Individual Corporate DirectorBoard Member Oct 1, 2019

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Acrmc Family MedicineWinchester, OH, CCN 363431 Rural health clinic Operational/Managerial Control (100%) Oct 1, 2019

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 44

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 44

NPI Registry JSON

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663891200000",
    "number": "1114640240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 MEDICAL CENTER DR",
            "city": "SEAMAN",
            "state": "OH",
            "postal_code": "456798002",
            "telephone_number": "937-386-3400",
            "fax_number": "937-386-3459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 ELLIOTT AVE",
            "city": "PEEBLES",
            "state": "OH",
            "postal_code": "456601028",
            "telephone_number": "937-587-2618",
            "fax_number": "937-587-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADAMS COUNTY REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-23",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A",
        "authorized_official_last_name": "DAGENBACH",
        "authorized_official_first_name": "PETE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "937-386-3007"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adams County Regional Medical Center (ACRMC) Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peebles, OH

Sources for this page

Verify at the official NPI Registry.