NPIMap

Organization Active NPI

Cameron Memorial Community Hospital Inc

Doing business as Cameron OB/GYN

  • Rural Health Clinic/Center
  • Angola, IN
National Provider Identifier
1417440264
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CAMERON MEMORIAL COMMUNITY HOSPITAL INC
Doing business as
Cameron OB/GYN
Practice address
306 E Maumee St Ste 101
Angola, IN 46703-2037
Phone
(260) 667-5670
Fax
(260) 667-5680
NPI assigned
Jun 7, 2018
Last updated
Jul 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Authorized official

Name
Angela Logan
Title
Ceo
Phone
(260) 667-5133

Specialties & licenses 1

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

Addresses

Primary practice location

306 E Maumee St Ste 101
Angola, IN 46703-2037

Mailing address

416 E Maumee St
Angola, IN 46703-2001
Phone (260) 667-5133

Other names 1

  • CAMERON OB/GYN Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040323001008 IN Part B Supplier - Clinic/Group Practice 9234020835 Receives reassigned benefits from 136 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Angola, IN; Fremont, IN; Fort Wayne, IN
O20180811000170 IN Part A Provider - Rural Health Clinic 9234020835 Practice locations: Angola, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417440264. Details of each certification follow.

Rural health clinic certification: CCN 158546

Legal name
CAMERON MEMORIAL COMMUNITY HOSPITAL INC
Doing business as
CAMERON OB/GYN
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 25, 2019
Last certification
Nov 25, 2019
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
306 E Maumee St
Ste 101
Angola, IN 46703-2037
Related CCNs
151315

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

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 6

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
15D2139026Cameron OB/GYN306 E Maumee Street, Suite 101, Angola, IN 46703Provider-performed microscopyOct 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
Cameron Memorial Community Hospital Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

306 E Maumee St
Ste 303
Angola, IN 46703
Phone (260) 665-8494

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
Carrie Vollmer-Sanders Individual Corporate Officer Jun 3, 2025
Todd C Rumsey Individual Corporate OfficerTreasurer Sep 30, 2013
Ann Rice Individual Corporate Officer Apr 25, 2023
Wendy Jean Stamper Individual Corporate Director Jan 1, 2019
Jonathan Orlando Cress Individual Corporate Officer Apr 25, 2023
Michael Connell Individual Corporate Officer Apr 25, 2023
Scott Gruner Individual Corporate Officer Jun 3, 2025
Janelle Sponsler Individual W-2 Managing EmployeeDirector of PT Accting May 1, 2021
Luke Andrews Individual Corporate Officer Jun 3, 2025
Angela M Logan Individual Corporate OfficerCeo May 1, 2021
Andrew Kleber Individual Corporate OfficerCfo Jun 3, 2025
Donna K Elbrecht Individual Corporate Officer Apr 25, 2023
Kendra Klink Individual Corporate Officer Jun 3, 2025
Cameron Memorial Community Hospital Inc Organization, Angola, IN Non-profit 5% Or Greater Direct Ownership Interest Apr 25, 2023 100%
John McCoy Individual Corporate OfficerVice Chair Sep 30, 2013
Charles L Maclean Individual Corporate Officer Jun 3, 2025

Owners & managing parties with NPI records 9

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Cameron Memorial Community Hospital IncAngola, IN, CCN 15Z315 Hospital Operational/Managerial Control Jan 1, 1989
Cameron Jointaccess Ortho & UrgentAngola, IN, CCN 158545 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 25, 2023
Cameron Family Medicine - NorthAngola, IN, CCN 158570 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2021
Cameron Family Medicine FremontFremont, IN, CCN 158571 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2023

Owned or controlled facilities with NPI records 5

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

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751846400000",
    "number": "1417440264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 E MAUMEE ST",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032001",
            "telephone_number": "260-667-5133",
            "fax_number": "260-665-7893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 E MAUMEE ST STE 101",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032037",
            "telephone_number": "260-667-5670",
            "fax_number": "260-667-5680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMERON MEMORIAL COMMUNITY HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-07",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "260-667-5133"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAMERON OB/GYN",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CAMERON OB/GYN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Angola, IN

Sources for this page

Verify at the official NPI Registry.