NPIMap

Organization Active NPI

Van Wert County Hospital Association

Doing business as Van Wert Rural Health Clinic

  • Rural Health Clinic/Center
  • Van Wert, OH
National Provider Identifier
1245857804
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
VAN WERT COUNTY HOSPITAL ASSOCIATION
Doing business as
Van Wert Rural Health Clinic
Practice address
214 Town Center Blvd
Van Wert, OH 45891-9086
Phone
(419) 605-0850
NPI assigned
Jun 30, 2020
Last updated
Oct 6, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
VAN WERT COUNTY HOSPITAL ASSOCIATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Authorized official

Name
Edgar Silalahi
Title
Cfo
Phone
(419) 238-2390

Specialties & licenses 1

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

Addresses

Primary practice location

214 Town Center Blvd
Van Wert, OH 45891-9086

Mailing address

1250 S Washington St
Van Wert, OH 45891-2551
Phone (419) 238-8873

Other practice location 1

140 Fox Rd Ste 201
Van Wert, OH 45891-2492
Phone (419) 238-2390

Other names 1

  • Van Wert Rural Health Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210112000834 OH Part A Provider - Rural Health Clinic 3173419405 Practice locations: Van Wert, OH
O20251021003677 OH Part B Supplier - Clinic/Group Practice 3173419405 Receives reassigned benefits from 20 practitioners
Practice locations: Van Wert, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245857804. Details of each certification follow.

Rural health clinic certification: CCN 363430

Legal name
VAN WERT COUNTY HOSPITAL ASSOCIATION
Doing business as
OHIOHEALTH VAN WERT RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 15, 2021
Last certification
Feb 15, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jun 28, 1905 in OH
Enrollment address
214 Towne Center Blvd
Van Wert, OH 45891-9086
Related CCNs
360071

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

Other NPIs with the same Medicare PAC ID 1

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

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
36D2201065Van Wert Rural Health Clinic214 Town Center Blvd, Van Wert, OH 45891Provider-performed microscopyNov 17, 2026

National Provider Directory

National Provider Directory
Part of
Van Wert County Hospital Association

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

140 Fox Rd
Ste 101
Van Wert, OH 45891
Phone (419) 238-8626

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
John Schwemer Individual Corporate DirectorBoard Member Feb 28, 2023
Wade Giffin Individual Corporate DirectorBoard Member Feb 28, 2023
Andy Rose Individual Corporate OfficerTreasurer Jul 1, 2023
Corporate DirectorBoard Member Feb 28, 2023
Nicholas P Honda Individual Corporate DirectorBoard Member Jan 1, 2024
Donna James Individual Corporate OfficerSecretary Feb 28, 2023
Corporate DirectorBoard Member Feb 28, 2023
Michael Coleman Individual Corporate DirectorBoard Member Feb 28, 2023
Stephen Markovich Individual Corporate OfficerPresident & Ceo, Ohiohealth Feb 28, 2023
W-2 Managing EmployeePresident & Ceo, Ohiohealth Feb 28, 2023
Sandy Doyle-Ahern Individual Corporate DirectorBoard Member Jul 1, 2023
Hee-Soo Jung Individual Corporate DirectorBoard Member Jul 1, 2025
David Harrison Individual Corporate DirectorBoard Member Feb 28, 2023
Arvind Mark Malik Individual Corporate DirectorBoard Member Jan 1, 2024
Carolyn S Kile Individual Corporate DirectorBoard Member Jul 1, 2023
Jeffrey D Hutchison Individual Corporate DirectorBoard Member Feb 28, 2023
Linda Hondros Individual Corporate OfficerVice Chairman Jul 1, 2024
Corporate DirectorBoard Member Feb 28, 2023
Karen Cook Individual Corporate DirectorBoard Member Feb 28, 2023
Mike Mahaffey Individual Corporate DirectorBoard Member Jul 1, 2023
Peggy Simmons Individual Corporate DirectorBoard Member Jan 1, 2024
Joseph S Lyren Individual Corporate OfficerVP Finance Feb 28, 2023
Jennifer Lynn Papp Individual Corporate DirectorBoard Member Oct 1, 2023
David Eichinger Individual Corporate DirectorBoard Member Feb 28, 2023
Elizabeth Ingram Individual Corporate OfficerChairman Jul 1, 2024
Corporate DirectorBoard Member Feb 28, 2023
Ohiohealth Corporation Organization, Columbus, OH Corporation 5% Or Greater Direct Ownership Interest Feb 28, 2023 100%

Owners & managing parties with NPI records 10

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

Facilities with the same owner 20

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 20

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.

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665014400000",
    "number": "1245857804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 S WASHINGTON ST",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458912551",
            "telephone_number": "419-238-8873",
            "fax_number": "419-232-2035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 TOWN CENTER BLVD",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458919086",
            "telephone_number": "419-605-0850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Fox Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Van Wert",
            "state": "OH",
            "postal_code": "458912492",
            "country_code": "US",
            "telephone_number": "419-238-2390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VAN WERT COUNTY HOSPITAL ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VAN WERT COUNTY HOSPITAL ASSOCIATION",
        "enumeration_date": "2020-06-30",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A",
        "authorized_official_last_name": "SILALAHI",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "419-238-2390"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Van Wert Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Van Wert, OH

Sources for this page

Verify at the official NPI Registry.