NPIMap

Organization Active NPI

Health Partners of Western Ohio

Doing business as Waite Health Center

  • Federally Qualified Health Center (FQHC)
  • Toledo, OH
National Provider Identifier
1306509757
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HEALTH PARTNERS OF WESTERN OHIO
Doing business as
Waite Health Center
Practice address
301 Morrison Dr
Toledo, OH 43605-2124
Phone
(419) 221-3072
NPI assigned
Oct 21, 2021
Last updated
Feb 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Authorized official

Name
Janis Sunderhaus
Title
Ceo
Phone
(419) 221-3072

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

301 Morrison Dr
Toledo, OH 43605-2124

Mailing address

329 N West St
Lima, OH 45801-4332
Phone (419) 221-3072

Other names 1

  • Waite Health Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150313002043 OH Part B Supplier - Clinic/Group Practice 9436139987 Receives reassigned benefits from 153 practitioners
28 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Toledo, OH; Tiffin, OH; New Carlisle, OH; Lima, OH; Bryan, OH; Defiance, OH; Harrod, OH; Holland, OH…
O20211213000549 OH Part A Provider - Federally Qualified Health Center (FQHC) 9436139987 Practice locations: Toledo, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306509757. Details of each certification follow.

Federally qualified health center certification: CCN 721931

Legal name
HEALTH PARTNERS OF WESTERN OHIO
Doing business as
WAITE HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 2, 2021
Last certification
Nov 2, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 18, 2002 in OH
Enrollment address
301 Morrison Dr
Toledo, OH 43605-2124

Other NPIs with the same Medicare PAC ID 21

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

View all 21

Other NPIs on the same Medicare enrollment 26

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

View all 26

National Provider Directory

National Provider Directory
Tax ID family
Allen County Health Par54 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

2200 Arlington Ave
Toledo, OH 43614
Phone (419) 671-2000

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Janis Sunderhaus Individual Corporate OfficerCeo Jul 1, 2003
W-2 Managing EmployeeCeo Jul 1, 2003
Operational/Managerial ControlCeo Jul 1, 2003
Angel Cowan Individual OtherBoard Member Nov 1, 2020
Joseph a. Dake Individual OtherBoard Member Feb 26, 2015
Lorna Simpson Individual OtherBoard Member Jan 28, 2016
Arlisa Hall Individual OtherBoard Member Sep 23, 2010
Anthony Lester Individual OtherBoard Member Oct 27, 2011
John Stanovich Individual OtherBoard Member Mar 1, 2014
Daisy Williamson Individual Other Apr 1, 2024
Rebecca Dershem Individual OtherTreasurer Oct 25, 2002
Mary Williamson Individual OtherVice President Oct 1, 2002
Loretta Jean Mankin Individual Corporate OfficerChief Integration Officer Jul 9, 2007
W-2 Managing EmployeeChief Financial Officer Jul 9, 2007
Operational/Managerial ControlChief Financial Officer Jul 9, 2007
William Stolly Individual OtherPresident Sep 1, 2010

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1306509757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 N WEST ST",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458014332",
            "telephone_number": "419-221-3072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MORRISON DR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436052124",
            "telephone_number": "419-221-3072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH PARTNERS OF WESTERN OHIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-21",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "SUNDERHAUS",
        "authorized_official_first_name": "JANIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "419-221-3072"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waite Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Waite Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.