NPIMap

Organization Active NPI

Knox Community Hospital

Doing business as Knox Community Hospital Swing Bed

  • Medicare Defined Swing Bed Hospital Unit
  • Mount Vernon, OH
National Provider Identifier
1366154064
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
KNOX COMMUNITY HOSPITAL
Doing business as
Knox Community Hospital Swing Bed
Practice address
1330 Coshocton Ave
Mount Vernon, OH 43050
Phone
(740) 393-9000
Fax
(740) 399-3859
NPI assigned
Dec 14, 2022
Last updated
Aug 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Authorized official

Name
Michael Ambrosiani, CFO
Title
Cfo
Phone
(740) 393-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

Primary practice location

1330 Coshocton Ave
Mount Vernon, OH 43050

Mailing address

1330 Coshocton Ave
Mount Vernon, OH 43050
Phone (740) 393-9000

Other names 1

  • Knox Community Hospital Swing Bed Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040722001173 OH Part B Supplier - Clinic/Group Practice 1153301833 Receives reassigned benefits from 202 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mount Vernon, OH; Mt Vernon, OH; Ontario, OH; Centerburg, OH; Galion, OH; Bucyrus, OH; Danville, OH; Fredericktown, OH…
O20230216002691 OH Part A Provider - Hospital 1153301833 Practice locations: Mount Vernon, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366154064. Details of each certification follow.

Hospital certification: CCN 36U040

Legal name
KNOX COMMUNITY HOSPITAL
Doing business as
KNOX COMMUNITY HOSPITAL SWING BED
Organization structure
CorporationNon-profit
Incorporated
Mar 2, 1977 in OH
Enrollment address
1330 Coshocton Ave
Mount Vernon, OH 43050-1440
Hospital Swing-Bed Unit
Hospital subgroups
Acute care

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

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory
Tax ID family
David McCann MD13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Marc Odenweller Individual Corporate DirectorBoard Member Jan 1, 2017
Judy Gregg Individual Corporate DirectorBoard Member Jan 1, 2024
Korey Kidwell Individual Corporate DirectorBoard Member Jan 1, 2016
Cindy Russo Individual Corporate OfficerCoo Jul 8, 2025
W-2 Managing EmployeeCoo Jul 8, 2025
Ian Watson Individual Corporate DirectorBoard Member Jan 1, 2013
Michael P Sullivan Individual Corporate DirectorBoard Member Jan 1, 2014
Vickie a Sant Individual Corporate DirectorBoard Member Jan 1, 2019
Teresa Bemiller Individual Corporate DirectorBoar Member Jan 1, 2025
Marci Cottingham Individual Corporate DirectorBoard Member Jan 1, 2025
Bruce White Individual Corporate OfficerCeo Jan 1, 2007
W-2 Managing EmployeeCeo Jan 1, 2007
Jeffrey Boucher Individual Corporate DirectorBoard Member Jan 10, 2016
Danielle Obrien Individual Corporate OfficerCfo Jan 1, 2007
W-2 Managing EmployeeCfo Jan 1, 2007
Julie Kornfield Individual Corporate DirectorBoard Member Jan 1, 2025
Cheri Butcher Individual Corporate DirectorBoard Member Jan 1, 2020
Sam Barone Individual Corporate DirectorBoard President Jan 10, 2018
Amy Murnen Individual Corporate DirectorBoard Member Jan 1, 2016

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 96

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 96

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1670976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723075200000",
    "number": "1366154064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 COSHOCTON AVE",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "43050",
            "telephone_number": "740-393-9000",
            "fax_number": "740-399-3859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 COSHOCTON AVE",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "43050",
            "telephone_number": "740-393-9000",
            "fax_number": "740-399-3859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOX COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-14",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A",
        "authorized_official_last_name": "AMBROSIANI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "740-393-9000",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Knox Community Hospital Swing Bed",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Vernon, OH

Sources for this page

Verify at the official NPI Registry.