NPIMap

Organization Active NPI

Galion Community Hospital

Doing business as Ontario Physician Practices

  • Rural Health Clinic/Center
  • Ontario, OH
National Provider Identifier
1194154294
Registry record updated Mar 26, 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
Ontario Physician Practices
Practice address
2981 W 4TH St
Ontario, OH 44906-1267
Phone
(419) 462-4561
NPI assigned
Nov 8, 2013
Last updated
Mar 26, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2014

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

Authorized official

Name
Mr. Donald E Draime
Title
Vice President/Cfo
Phone
(419) 468-0501

Specialties & licenses 1

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

Addresses

Primary practice location

2981 W 4TH St
Ontario, OH 44906-1267

Mailing address

2981 W 4TH St
Ontario, OH 44906-1267

Other names 1

  • Ontario Physician Practices Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140829001477 OH Part A Provider - Rural Health Clinic 5496737439 Practice locations: Ontario, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194154294. Details of each certification follow.

Rural health clinic certification: CCN 363410

Legal name
GALION COMMUNITY HOSPITAL
Doing business as
ONTARIO PHYSICIAN PRACTICES
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 24, 2015
Last certification
May 24, 2015
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Nov 5, 1954 in OH
Enrollment address
2981 W 4TH St
Ontario, OH 44906-1267
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

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
36D2033336Ontario Physician Practices2981 W Fourth St, Mansfield, OH 44906Certificate of waiverNov 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
GCH Medical Practice27 organizations share this tax ID, including this one

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 9

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

NameRoleSinceShare
Kay E McDonald Individual Corporate DirectorBoard Member Jan 28, 2010
Michelle L Burgin Individual W-2 Managing EmployeeVP of Physician Services Dec 31, 2007
Jerome B Morasko Individual Corporate OfficerPresident, Ceo Apr 13, 2009
Philip M Brown Individual Corporate DirectorBoard Member Jan 28, 2010
John a Basinger Individual Corporate DirectorBoard Member Jan 27, 2011
Joseph Shadeed Individual Corporate DirectorBoard Member Jan 27, 2011
Donald E Draime Individual Corporate OfficerVP, Cfo Mar 29, 2010
Sherri L Clevenger Individual Corporate DirectorBoard Member Jan 28, 2010
Jason R McMullen Individual Corporate DirectorBoard Member Jan 27, 2011

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": "1383868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395792000000",
    "number": "1194154294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2981 W 4TH ST",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449061267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2981 W 4TH ST",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449061267",
            "telephone_number": "419-462-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALION COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-08",
        "last_updated": "2014-03-26",
        "status": "A",
        "authorized_official_last_name": "DRAIME",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VICE PRESIDENT/CFO",
        "authorized_official_telephone_number": "419-468-0501",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ontario Physician Practices",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ontario, OH

Sources for this page

Verify at the official NPI Registry.