NPIMap

Organization Active NPI

Mary Rutan Hospital

  • Rural Health Clinic/Center
  • Bellefontaine, OH
National Provider Identifier
1316785306
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MARY RUTAN HOSPITAL
Practice address
118 Dowell Ave
Bellefontaine, OH 43311-2305
Phone
(937) 593-5437
Fax
(937) 593-0110
NPI assigned
Jul 16, 2024
Organization subpart
Yes
Parent organization
MARY RUTAN HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Authorized official

Name
Thomas Denbow
Title
VP of Finance and Development
Phone
(937) 651-6688

Specialties & licenses 1

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

Addresses

Primary practice location

118 Dowell Ave
Bellefontaine, OH 43311-2305

Mailing address

118 Dowell Ave
Bellefontaine, OH 43311-2305
Phone (937) 593-5437

Other names 1

  • Mary Rutan Pediatrics Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031124000531 OH Part B Supplier - Clinic/Group Practice 9032013792 Receives reassigned benefits from 132 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bellefontaine, OH; Waynesfield, OH; Urbana, OH; Saint Paris, OH; Russells Point, OH; Lima, OH; Lakeview, OH; Kenton, OH…
O20240827002567 OH Part A Provider - Rural Health Clinic 9032013792 Practice locations: Bellefontaine, OH

Rural health clinic certification: CCN 363883

Legal name
MARY RUTAN HOSPITAL
Doing business as
MARY RUTAN PEDIATRICS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 2, 2025
Last certification
Jul 2, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Nov 3, 1983 in OH
Enrollment address
118 Dowell Ave
Bellefontaine, OH 43311-2305

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory
Tax ID family
Mary Rutan Hospital-Emergency Department12 organizations share this tax ID, including this one
Part of
Mary Rutan Hospital-Emergency Department

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

118 Dowell Ave
Bellefontaine, OH 43311
Phone (937) 593-5437

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Thomas Denbow Individual Corporate OfficerVP of Finance & Development Jun 1, 2023
Corporate DirectorVP of Finance & Development Jun 1, 2023
Richard Gildow Individual Corporate DirectorBoard Director Jan 1, 1992
John Hatcher Individual Corporate DirectorBoard Director Mar 19, 2012
Charles Chamberlain Individual Corporate DirectorBoard Director Mar 18, 2013
Barbara Haushalter Individual Corporate DirectorBoard Director Mar 25, 2019
Stephen Shellhaas Individual Corporate DirectorBoard Director Mar 19, 2018
Jeffrey Holycross Individual Corporate DirectorBoard Director Mar 19, 2012
Scott a Abraham Individual Corporate DirectorBoard Director Mar 23, 2015
Christina M Myers Individual Corporate OfficerChief Operating Officer Aug 30, 2021
Corporate DirectorChief Operating Officer Aug 30, 2021
Darin Olson Individual Corporate DirectorBoard Director Mar 23, 2015
Kelly J Kauffman Individual Corporate DirectorBoard Director Mar 27, 2023
Thomas Simon Individual Corporate DirectorBoard Director Mar 25, 2019
Chad a Ross Individual Contracted Managing EmployeePresident & Ceo Aug 30, 2021
Corporate OfficerPresident & Ceo Mar 23, 2015
Corporate DirectorPresident & Ceo Mar 23, 2015
Mary Rutan Health Association Organization, Bellefontaine, OH Corporation, Non-profit Operational/Managerial Control Dec 28, 1983 100%
Other Dec 28, 1983 100%
Dan S Willoby Individual Corporate DirectorBoard Director Mar 27, 2023
Joenee D Purcell Individual Corporate DirectorBoard Director Mar 17, 2014
Grant K Varian Individual Corporate DirectorBoard Director Mar 25, 2024
Paige E Duff Individual Corporate DirectorBoard Director Mar 25, 2024

Facilities with the same owner 3

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1316785306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 DOWELL AVE",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433112305",
            "telephone_number": "937-593-5437",
            "fax_number": "937-593-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 DOWELL AVE",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433112305",
            "telephone_number": "937-593-5437",
            "fax_number": "937-593-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY RUTAN HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARY RUTAN HOSPITAL",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "DENBOW",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "VP OF FINANCE AND DEVELOPMENT",
        "authorized_official_telephone_number": "937-651-6688"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mary Rutan Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bellefontaine, OH

Sources for this page

Verify at the official NPI Registry.