NPIMap

Organization Active NPI

Otterbein St. Marys

  • Assisted Living Facility
  • St. Marys, OH
National Provider Identifier
1154984565
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
OTTERBEIN ST. MARYS
Practice address
11230 State Route 364
St. Marys, OH 45885-9534
Phone
(419) 394-2366
NPI assigned
Apr 22, 2019
Organization subpart
Yes
Parent organization
OTTERBEIN ST. MARYSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

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

Authorized official

Name
James Chris Green
Title
Treasurer & Cfo
Phone
(513) 933-5418

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

11230 State Route 364
St. Marys, OH 45885-9534

Mailing address

580 North State Route 741
Lebanon, OH 45036-8839
Phone (513) 933-5401

Other names 1

  • Otterbein St. Marys Assisted Living Other name

National Provider Directory

National Provider Directory
Tax ID family
Otterbein St Marys2 organizations share this tax ID, including this one
Part of
Otterbein St Marys

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555891200000",
    "number": "1154984565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 NORTH STATE ROUTE 741",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450368839",
            "telephone_number": "513-933-5401",
            "fax_number": "513-932-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11230 STATE ROUTE 364",
            "city": "ST. MARYS",
            "state": "OH",
            "postal_code": "458859534",
            "telephone_number": "419-394-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTTERBEIN ST. MARYS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OTTERBEIN ST. MARYS",
        "enumeration_date": "2019-04-22",
        "last_updated": "2019-04-22",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "CHRIS",
        "authorized_official_title_or_position": "TREASURER & CFO",
        "authorized_official_telephone_number": "513-933-5418"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Otterbein St. Marys Assisted Living",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in St. Marys, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.