NPIMap

Organization Active NPI

Open Door Health Services, Inc.

Doing business as Open Door Health Services YMCA

  • Federally Qualified Health Center (FQHC)
  • Muncie, IN
National Provider Identifier
1376349316
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
OPEN DOOR HEALTH SERVICES, INC.
Doing business as
Open Door Health Services YMCA
Practice address
615 N Walnut St
Muncie, IN 47305-1458
Phone
(765) 286-7000
NPI assigned
Feb 20, 2025
Last updated
Feb 20, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
OPEN DOOR HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Authorized official

Name
Bryan Ayars
Title
Ceo/President
Phone
(765) 286-6000

Specialties & licenses 1

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

Addresses

Primary practice location

615 N Walnut St
Muncie, IN 47305-1458

Mailing address

PO Box 1676
Muncie, IN 47308-1676

Other names 1

  • Open Door Health Services YMCA Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040115000592 IN Part B Supplier - Clinic/Group Practice 5890696603 Receives reassigned benefits from 58 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Muncie, IN; Hartford City, IN; Anderson, IN
O20250430002213 IN Part A Provider - Federally Qualified Health Center (FQHC) 5890696603 Practice locations: Muncie, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376349316. Details of each certification follow.

Federally qualified health center certification: CCN C51091

Legal name
OPEN DOOR HEALTH SERVICES INC
Doing business as
OPEN DOOR HEALTH SERVICES YMCA
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 29, 2025
Last certification
Apr 29, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
615 N Walnut St
Muncie, IN 47305-1458

Other NPIs with the same Medicare PAC ID 7

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.

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
15D2267933Open Door Health Services, Inc615 N Walnut St, Ste A104, Muncie, IN 47305Certificate of waiverSep 1, 2026

National Provider Directory

National Provider Directory
Tax ID family
Open Door Health Srvcs Inc9 organizations share this tax ID, including this one
Part of
Open Door Health Srvcs Inc

Other organizations with this tax ID 8

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1912 Jackson St
Anderson, IN 46016

2101 Jackson St
Ste 206
Anderson, IN 46016
Phone (765) 646-8523

333 S Madison St
Ste 79
Muncie, IN 47305
Phone (833) 315-1520

3715 S Madison St
Muncie, IN 47302
Phone (765) 281-4257

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Allen Johnstone Individual Corporate DirectorBoard Member Apr 18, 2019
Maricel Driscoll Individual Corporate DirectorBoard Member Jan 1, 2025
Keeta Edsall Individual Corporate DirectorBoard Member Jan 1, 2025
Susan Dillon Individual Corporate DirectorBoard Member Mar 25, 2020
Patricia Kennedy Individual Corporate DirectorBoard Member Apr 18, 2019
Alan Spaulding Individual Corporate DirectorBoard Member Jan 1, 2025
Jeff Huff Individual Corporate DirectorBoard Treasurer Apr 18, 2019
Open Door Health Services Inc Organization, Muncie, IN Non-profit 5% Or Greater Direct Ownership Interest Apr 1, 2025 100%
Jennifer Parks-Strack Individual Corporate DirectorBoard Secretary Jan 20, 2021
Jean Marie Place Individual Corporate DirectorBoard Member Oct 7, 2020
Kenyonta Hudson Individual Corporate DirectorBoard Vice Chairman Apr 18, 2019
Bryan W Ayars Individual Corporate OfficerCeo Jun 1, 2016 100%
W-2 Managing EmployeeCeo Jun 1, 2016 100%
Kathy L Vermeulen Individual Corporate DirectorBoard Member Nov 21, 2019
Annette Craycraft Individual Corporate DirectorBoard Chairman Sep 18, 2019
Brian Reed Individual Corporate DirectorBoard Member Jan 1, 2025

Owners & managing parties with NPI records 7

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

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Open Door Pediatrics and Family MedicineMuncie, IN, CCN 151046 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2018
Open Door School-Based HealthMuncie, IN, CCN 151135 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Mar 24, 1997
Open Door Health Services Blackford CountyHartford City, IN, CCN C51032 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 1, 2024

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 77

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 77

NPI Registry JSON

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

{
    "created_epoch": "1740009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740009600000",
    "number": "1376349316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1676",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473081676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N WALNUT ST",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473051458",
            "telephone_number": "765-286-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN DOOR HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OPEN DOOR HEALTH SERVICES, INC.",
        "enumeration_date": "2025-02-20",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-17",
        "status": "A",
        "authorized_official_last_name": "AYARS",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "765-286-6000"
    },
    "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": "Open Door Health Services YMCA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Muncie, IN

Sources for this page

Verify at the official NPI Registry.