NPIMap

Organization Active NPI

Physician's Choice Hospital - Fremont, LLC

  • Rural Acute Care Hospital
  • Fremont, OH
National Provider Identifier
1215174040
Registry record updated Oct 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
Legal business name
PHYSICIAN'S CHOICE HOSPITAL - FREMONT, LLC
Practice address
2390 Enterprise St
Fremont, OH 43420-8507
Phone
(567) 201-2911
Fax
(567) 201-2914
NPI assigned
Jan 15, 2009
Last updated
Oct 28, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2010

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

Authorized official

Name
Dr. Jerome Anthony McTague, MD, JDNPI 1194758540
Title
Managing Member
Phone
(419) 461-1057

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X Primary

Addresses

Primary practice location

2390 Enterprise St
Fremont, OH 43420-8507

Mailing address

2390 Enterprise St
Fremont, OH 43420-8507
Phone (567) 201-2911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215174040. Details of each certification follow.

Hospital certification: CCN 360356

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
PHYSICIAN'S CHOICE HOSPITAL - FREMONT, LLC
Certification status
Terminated Voluntary: merger or closure, Mar 14, 2012
Provider type (POS)
Hospital – Short-term
Participating since
Sep 16, 2009
Last certification
Sep 16, 2009
Beds
8
Ownership / control type
Private (not for profit)
Facility address
2390 Enterprise Drive
Fremont, OH 43420

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1231977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288224000000",
    "number": "1215174040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2390 ENTERPRISE ST",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434208507",
            "telephone_number": "567-201-2911",
            "fax_number": "567-201-2914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2390 ENTERPRISE ST",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434208507",
            "telephone_number": "567-201-2911",
            "fax_number": "567-201-2914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN'S CHOICE HOSPITAL - FREMONT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-15",
        "last_updated": "2010-10-28",
        "status": "A",
        "authorized_official_last_name": "MCTAGUE",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "419-461-1057",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, JD"
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, OH

Sources for this page

Verify at the official NPI Registry.