NPIMap

Organization Active NPI

City Hospital Association

Doing business as Wellsville Clinic

  • Rural Health Clinic/Center
  • Wellsville, OH
National Provider Identifier
1447946215
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CITY HOSPITAL ASSOCIATION
Doing business as
Wellsville Clinic
Practice address
601 Main St
Wellsville, OH 43968-1662
Phone
(330) 362-4799
NPI assigned
Apr 14, 2023
Last updated
Sep 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Authorized official

Name
Andrew C Hibdon
Title
Manager
Phone
(530) 244-5400

Specialties & licenses 1

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

Addresses

Primary practice location

601 Main St
Wellsville, OH 43968-1662

Mailing address

601 Main St
Wellsville, OH 43968-1662

Other names 1

  • Wellsville Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230523002310 OH Part A Provider - Rural Health Clinic 0446220644 Practice locations: Wellsville, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447946215. Details of each certification follow.

Rural health clinic certification: CCN 363442

Legal name
THE CITY HOSPITAL ASSOCIATION
Doing business as
WELLSVILLE CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 18, 2023
Last certification
Aug 18, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jun 2, 1896 in OH
Enrollment address
601 Main St
Wellsville, OH 43968-1662
Related CCNs
360096

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

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Technician Services Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

416 Jackson St
East Liverpool, OH 43920
Phone (330) 386-7870

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Prime Healthcare Services, Inc Organization, Ontario, CA Corporation, For-profit Other Feb 1, 2016
Steven Aleman Individual OtherCorporate Chief Financial Officer Jun 1, 2020
Christopher Doan Individual Corporate OfficerManaging Associate General Counsel Apr 24, 2017
Krista McFadden Individual Corporate OfficerChief Executive Officer Jul 5, 2022
Corporate DirectorDirector Jul 5, 2022
W-2 Managing EmployeeChief Executive Officer Jul 5, 2022
Prime Healthcare Foundation Inc Organization, Ontario, CA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Feb 1, 2016 100%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 29

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

View all 29

Practitioners & affiliated clinicians

Practitioners 8

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": "1681430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693526400000",
    "number": "1447946215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MAIN ST",
            "city": "WELLSVILLE",
            "state": "OH",
            "postal_code": "439681662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 MAIN ST",
            "city": "WELLSVILLE",
            "state": "OH",
            "postal_code": "439681662",
            "telephone_number": "330-362-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-14",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A",
        "authorized_official_last_name": "HIBDON",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "530-244-5400"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellsville Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wellsville Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wellsville, OH

Sources for this page

Verify at the official NPI Registry.