Community Memorial Hospital

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

35090360 Issued in OH

Legal business name

COMMUNITY MEMORIAL HOSPITAL

Doing business as

Edgerton Family Health Center

Practice address

104 S. West Street
Edgerton, OH 43517

Phone

(419) 298-2478

NPI assigned

Jun 14, 2018

Last updated

Oct 23, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

COMMUNITY MEMORIAL HOSPITALAs reported in NPPES

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

Authorized official

Name

Janey Zachrich

Title

Ceo

Phone

(419) 542-5566

Specialties & licenses 1

Addresses

Other names 1

• Edgerton Family Health Center Doing business as

Part of

Daniel L Underwood

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.

• Michael Kooistra Jr., MD

  • Family Medicine Physician
  • Auburn, IN
  • NPI 1508864380
  NPD (past)
• Jessica L Slattery, CNP

  • Nurse Practitioner
  • Auburn, IN
  • NPI 1245518927
  NPD (past)

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571788800000",
    "number": "1336632280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 COLUMBUS ST",
            "city": "HICKSVILLE",
            "state": "OH",
            "postal_code": "435261250",
            "telephone_number": "419-542-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S. WEST STREET",
            "city": "EDGERTON",
            "state": "OH",
            "postal_code": "43517",
            "telephone_number": "419-298-2478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY MEMORIAL HOSPITAL",
        "enumeration_date": "2018-06-14",
        "last_updated": "2019-10-23",
        "status": "A",
        "authorized_official_last_name": "ZACHRICH",
        "authorized_official_first_name": "JANEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "419-542-5566"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "OH",
            "license": "35090360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edgerton Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Adams Helping Hands Home Care, LLC (Visiting Angels of Northwest Ohio)
• Michael Adams
• All Heart Home Care LLC (Visiting Angels)
• Howard J Aube, D.D.S. INC
• John Stanley Casbere, DC
• Katlyn Nicole Craig
• Dream Haven LLC
• Edgerton Local SD
• Edgerton Long Term Care, Inc. (Park View Nursing Center)
• Heidi Ann Foster-Johnson, L.I.S.W.

• Rural Health Clinic/Center in Edgerton, OH
• Providers in Edgerton, OH by specialty
• Rural Health Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.