NPIMap

Organization Active NPI

Firelands Regional Medical Center

Doing business as Firelands Counseling & Recovery Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tiffin, OH
National Provider Identifier
1154372381
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
FIRELANDS REGIONAL MEDICAL CENTER
Doing business as
Firelands Counseling & Recovery Services
Practice address
76 Ashwood Dr
Tiffin, OH 44883-1908
Phone
(419) 448-9440
Fax
(419) 448-5155
NPI assigned
May 12, 2006
Last updated
Feb 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Authorized official

Name
Mr. Robert Moore
Title
Executive Vice President Legal
Phone
(419) 557-7400

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

76 Ashwood Dr
Tiffin, OH 44883-1908

Mailing address

76 Ashwood Dr
Tiffin, OH 44883-1908
Phone (419) 448-9440

Other practice location 1

97 Houpt Dr Rm W
Upper Sandusky, OH 43351-8904
Phone (419) 294-4388

Other practice location 2

675 Bartson Rd
Fremont, OH 43420-9672
Phone (419) 332-5524

Other practice location 3

335 Buckeye Blvd
Port Clinton, OH 43452-1423
Phone (419) 734-2942

Other identifiers 2

IdentifierTypeStateIssuer
6830OtherOHMACSIS UPI
3293725MedicaidOH

Other names 1

  • Firelands Counseling & Recovery Services Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20021030000000 OH Part A Provider - Hospital 6103734645 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20040415000236 OH Part B Supplier - Clinic/Group Practice 6103734645 Receives reassigned benefits from 36 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sandusky, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154372381. Details of each certification follow.

Hospital certification: CCN 360025

Legal name
FIRELANDS REGIONAL MEDICAL CENTER
Doing business as
FIRELANDS PROFESSIONAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Aug 16, 2010
Beds
400
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Feb 25, 1919 in OH
Enrollment address
1111 Hayes Ave
Sandusky, OH 44870-3323
Other Hospital Practice Location
Hospital subgroups
General, Acute care, Psychiatric, Rehabilitation

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

Other NPIs on the same Medicare enrollment 7

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Firelands Regional Medical CenterCCN 360025 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

97 Houpt Dr
Rm W
Upper Sandusky, OH 43351
Phone (419) 294-4388

Ownership & related parties

All disclosed owners & managing parties 47

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

NameRoleSinceShare
Steven Benedict Individual Corporate Director May 26, 2020
Justin Harris Individual Corporate Director May 9, 2022
Bryan Kasper Individual Corporate DirectorBoard Member May 5, 2008
John Hoty Individual Corporate DirectorBoard Member May 7, 2012
Maurice McDermond Individual Corporate DirectorBoard Member Oct 30, 2002
Roger Gundlach Individual Corporate DirectorBoard Member May 9, 2011
James Preston Individual Corporate DirectorBoard Member Feb 28, 1994
James Scherger Individual Corporate Director May 28, 2019
Kevin Kieffer Individual Corporate Director May 15, 2023
Richard R Keller Individual Corporate DirectorBoard Member Apr 29, 2002
Mary Hill Individual Corporate DirectorBoard Member Apr 25, 2016
William P McGuinn Individual Corporate DirectorBoard Member Apr 26, 2010
Jeremy L Normington-Slay Individual Corporate OfficerPresident & Ceo Oct 1, 2018
Operational/Managerial ControlPresident & Ceo Oct 1, 2018
Theodore Kastor Individual Corporate DirectorBoard Member May 9, 2011
Matthew Kosior Individual Corporate Director May 17, 2021
Fredric Howard Itzkowitz Individual Corporate DirectorBoard Member Apr 25, 2005
Carlos Lowell Individual Corporate DirectorBoard Member May 7, 2007
Karl Lee Oberer Individual Corporate DirectorBoard Member Apr 26, 2004
Wendy S Schmiedl Individual Corporate DirectorBoard Member May 6, 2013
Katherine Chesbro Individual Corporate DirectorBoard Member May 6, 2013
Thomas Foster Individual Corporate DirectorBoard Member Apr 23, 2018
James Wible Individual Corporate DirectorBoard Member Oct 30, 2002
Janice W Warner Individual Corporate DirectorBoard Member May 4, 2015
Allen Nickles Individual Corporate DirectorBoard Member Oct 30, 2002
Leon Wieber Individual Corporate DirectorBoard Member Oct 30, 2002
Curtis Johnson Individual Corporate DirectorBoard Member Apr 23, 2018
James Miller Individual Corporate DirectorBoard Vice Chair May 9, 2011
James Hart Individual Corporate DirectorBoard Member Apr 23, 2018
Scott M Campbell Individual Corporate DirectorBoard Member May 4, 2015
Steve Lichtcsien Individual Corporate DirectorBoard Member May 7, 2012
Chrissy Wostmann Individual Corporate DirectorBoard Member Apr 23, 2018
Lee a Alexakos Individual Corporate DirectorBoard Member May 4, 2015
Thomas B Williamson Individual Corporate DirectorBoard Member Jan 1, 2018
Gregory Graves Individual Corporate Director May 9, 2022
Robert Moore Individual Corporate OfficerEvp & General Counsel Jan 24, 2022
Darlene M Crooks Individual Corporate DirectorBoard Member May 4, 2015
Luvada S Wilson Individual Corporate DirectorBoard Member May 5, 2014
Paula Rengel Individual Corporate DirectorBoard Member Oct 30, 2002
James Spicer Individual Corporate DirectorVP, Operations & Cao May 25, 2004
W-2 Managing EmployeeVP, Operations & Cao May 25, 2004
John Bacon Individual Corporate OfficerBoard Chair Mar 1, 1984
Bradley William Mitchel Individual Corporate DirectorBoard Member Apr 23, 2018
Kevin J Riley Individual Corporate OfficerCfo Nov 28, 2022
Carol Wolfe Individual Corporate DirectorBoard Member Oct 30, 2002
Eugene Sanders Individual Corporate DirectorBoard Member May 6, 2013
Daniel Keller Individual Corporate DirectorBoard Member May 1, 2006
Timothy Mayles Individual Corporate DirectorBoard Member Apr 25, 2016
James Stouffer Individual Corporate DirectorBoard Member May 9, 2011

Owners & managing parties with NPI records 9

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

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 395

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 395

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675814400000",
    "number": "1154372381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 ASHWOOD DR",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "448831908",
            "telephone_number": "419-448-9440",
            "fax_number": "419-448-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 ASHWOOD DR",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "448831908",
            "telephone_number": "419-448-9440",
            "fax_number": "419-448-5155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "97 Houpt Dr Rm W",
            "address_purpose": "LOCATION",
            "city": "Upper Sandusky",
            "state": "OH",
            "postal_code": "433518904",
            "country_code": "US",
            "telephone_number": "419-294-4388",
            "fax_number": "419-294-5788",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "675 Bartson Rd",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "OH",
            "postal_code": "434209672",
            "country_code": "US",
            "telephone_number": "419-332-5524",
            "fax_number": "419-332-7581",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "335 Buckeye Blvd",
            "address_purpose": "LOCATION",
            "city": "Port Clinton",
            "state": "OH",
            "postal_code": "434521423",
            "country_code": "US",
            "telephone_number": "419-734-2942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FIRELANDS REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT LEGAL",
        "authorized_official_telephone_number": "419-557-7400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MACSIS  UPI",
            "identifier": "6830",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3293725",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Firelands Counseling & Recovery Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Firelands Counseling & Recovery Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tiffin, OH

Sources for this page

Verify at the official NPI Registry.