Wyandot Memorial Hospital

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

0002-HSP Issued in OH

Legal business name

WYANDOT MEMORIAL HOSPITAL

Doing business as

Wyandot Memorial Home Health and Hospice

Practice address

105 Houpt Dr
Upper Sandusky, OH 43351-9201

Phone

(419) 294-5787

Fax

(419) 294-4721

NPI assigned

Nov 18, 2005

Last updated

Oct 26, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ty R Shaull

Title

President and Ceo

Phone

(419) 294-4991

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wyandot Memorial Home Health and Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194707786. Details of each certification follow.

• CCN 361535 Hospice · Active · Details

Hospice certification: CCN 361535

Legal name

WYANDOT MEMORIAL HOSPITAL

Doing business as

HOSPICE OF WYANDOT MEMORIAL HOSPITAL

Certification status

Active

Provider type (POS)

Hospice

Participating since

Apr 19, 1989

Last certification

May 20, 2021

Ownership / control type

Non-Profit - Other

Organization structure

OtherNon-profit

Enrollment address

105 Houpt Dr
Upper Sandusky, OH 43351-9201

Other NPIs on the same Medicare enrollment 1

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

• Wyandot Memorial Hospital

  dba Hospice of Wyandot Memorial Hospital

  • Community Based Hospice Care Agency
  • Upper Sandusky, OH
  • NPI 1629846548

  O20210203003035

  Same enrollment

Listed as

Hospice of Wyandot Memorial HospitalCCN 361535 · All quality measures

Ownership

For-Profit

Certified

Apr 19, 1989

Medicare certification status

ActiveFrom the Provider of Services file

All disclosed owners & managing parties 11

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

Owners & managing parties with NPI records 1

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

• Peter Joseph Schuler, MD

  • General Practice Physician
  • Upper Sandusky, OH
  • NPI 1376512426

  Operational/Managerial Control, W-2 Managing Employee

  CMS ownership

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Wyandot Memorial Hospital

  dba Hospice of Wyandot Memorial Hospital

  • Community Based Hospice Care Agency
  • Upper Sandusky, OH
  • NPI 1629846548

  Sold to, 2020-11-15

  CMS change of ownership

Affiliated clinicians 1

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

• Peter Joseph Schuler, MD

  • General Practice Physician
  • Upper Sandusky, OH
  • NPI 1376512426

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1194707786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 HOUPT DR",
            "city": "UPPER SANDUSKY",
            "state": "OH",
            "postal_code": "433519201",
            "telephone_number": "419-294-5787",
            "fax_number": "419-294-4721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 HOUPT DR",
            "city": "UPPER SANDUSKY",
            "state": "OH",
            "postal_code": "433519201",
            "telephone_number": "419-294-5787",
            "fax_number": "419-294-4721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYANDOT MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "SHAULL",
        "authorized_official_first_name": "TY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "419-294-4991"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "OH",
            "license": "0002-HSP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0820133",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wyandot Memorial Home Health and Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wyandot Memorial Home Health and Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community Based Hospice Care Agency in Upper Sandusky, OH
• Providers in Upper Sandusky, OH by specialty
• Community Based Hospice Care Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.