NPIMap

Organization Active NPI

Galion Community Hospital

Doing business as GCH Physician Practice, Portland Way Campus

  • Rural Health Clinic/Center
  • Galion, OH
National Provider Identifier
1164655981
Registry record updated Apr 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GALION COMMUNITY HOSPITAL
Doing business as
GCH Physician Practice, Portland Way Campus
Practice address
270 Portland Way S
Galion, OH 44833-2362
Phone
(419) 468-4841
NPI assigned
Aug 27, 2009
Last updated
Apr 24, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
GALION COMMUNITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 24, 2014

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

Authorized official

Name
Donald Eric Draime
Title
Cfo
Phone
(419) 468-0501

Specialties & licenses 1

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

Addresses

Primary practice location

270 Portland Way S
Galion, OH 44833-2362

Mailing address

269 Portlandway South
Galion, OH 44833-2312
Phone (419) 468-4841

Other names 1

  • GCH Physician Practice, Portland Way Campus Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090803000366 OH Part A Provider - Rural Health Clinic 5496737439 Practice locations: Galion, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164655981. Details of each certification follow.

Rural health clinic certification: CCN 363984

Legal name
GALION COMMUNITY HOSPITAL
Doing business as
GCH PHYSICIAN PRACTICES, PORTLAND WAY CAMPUS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 10, 2010
Last certification
Dec 22, 2015
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Nov 5, 1954 in OH
Enrollment address
270 Portland S Way
Galion, OH 44833-2362
Related CCNs
361325

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

Other NPIs with the same Medicare PAC ID 16

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

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Galion Hospital27 organizations share this tax ID, including this one
Part of
Galion Hospital

Other organizations with this tax ID 26

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

View all 26

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Donald Barr Individual Corporate DirectorBoard Member Aug 1, 2009
Jeffrey Underwood Individual Corporate DirectorBoard Member Jan 1, 2014
Mark Schneider Individual Corporate DirectorBoard Member Aug 1, 2009
Linda Chambers Individual Corporate DirectorBoard Member Aug 1, 2009
Kymberly Fox Individual Corporate DirectorBoard Member Aug 1, 2009
Kay E McDonald Individual Corporate DirectorBoard Member Dec 3, 2014
Rex Cramer Individual Corporate DirectorBoard Member Aug 1, 2009
Charles Walker Individual Corporate Director Aug 1, 2009
Jerome B Morasko Individual Contracted Managing EmployeeCeo Apr 13, 2009
Corporate OfficerCeo Apr 13, 2009
W-2 Managing EmployeeCeo Apr 13, 2009
Eric Geyer Individual Corporate DirectorBoard Member Aug 1, 2009
Philip M Brown Individual Corporate DirectorBoard Member Dec 3, 2014
John a Basinger Individual Corporate DirectorBoard Member Dec 3, 2014
Joseph Shadeed Individual Corporate DirectorBoard Member Dec 3, 2014
Donald E Draime Individual Corporate OfficerCfo Mar 29, 2010
Corporate DirectorCfo Mar 29, 2010
Sherri L Clevenger Individual Corporate DirectorBoard Member Dec 3, 2014
Douglas Schilling Individual Corporate DirectorBoard Member Jan 1, 2007
Jason R McMullen Individual Corporate DirectorBoard Member Dec 3, 2014
Donald Plotts Individual Corporate DirectorBoard Member Jan 1, 2014

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Bucyrus Community HospitalBucyrus, OH, CCN 361316 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 31, 2010
Avita OntarioOntario, OH, CCN 360365 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 8, 2015
GCH Physician Practice Gaius StreetBucyrus, OH, CCN 363411 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 5, 1954

Owned or controlled facilities with NPI records 3

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

NPI Registry JSON

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398297600000",
    "number": "1164655981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 PORTLANDWAY SOUTH",
            "city": "GALION",
            "state": "OH",
            "postal_code": "448332312",
            "telephone_number": "419-468-4841",
            "fax_number": "419-468-2381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 PORTLAND WAY S",
            "city": "GALION",
            "state": "OH",
            "postal_code": "448332362",
            "telephone_number": "419-468-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALION COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GALION COMMUNITY HOSPITAL",
        "enumeration_date": "2009-08-27",
        "last_updated": "2014-04-24",
        "status": "A",
        "authorized_official_last_name": "DRAIME",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "419-468-0501"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GCH Physician Practice, Portland Way Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Galion, OH

Sources for this page

Verify at the official NPI Registry.