NPIMap

Organization Active NPI

Orrville Hospital Foundation

Doing business as Tuscarawas Health Center of Aultman Orrville Hospital

  • Rural Health Clinic/Center
  • Dover, OH
National Provider Identifier
1477150308
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ORRVILLE HOSPITAL FOUNDATION
Doing business as
Tuscarawas Health Center of Aultman Orrville Hospital
Practice address
603 Monroe St
Dover, OH 44622-2046
Phone
(330) 364-8889
Fax
(330) 343-7505
NPI assigned
Oct 5, 2020
Last updated
Feb 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Authorized official

Name
Adam M Luntz
Title
Cfo
Phone
(330) 363-3889

Specialties & licenses 1

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

Addresses

Primary practice location

603 Monroe St
Dover, OH 44622-2046

Mailing address

PO Box 80690
Canton, OH 44708-0690
Phone (330) 479-8705

Other names 1

  • Tuscarawas Health Center of Aultman Orrville Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201228000861 OH Part A Provider - Rural Health Clinic 7911890546 Practice locations: Dover, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477150308. Details of each certification follow.

Rural health clinic certification: CCN 363429

Legal name
ORRVILLE HOSPITAL FOUNDATION
Doing business as
TUSCARAWAS HEALTH CENTER OF AULTMAN ORRVILLE HOSPITAL
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 29, 2020
Last certification
Dec 29, 2020
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Dec 26, 1985 in OH
Enrollment address
603 Monroe St
Dover, OH 44622-2046
Related CCNs
361323

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

Other NPIs with the same Medicare PAC ID 10

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

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
36D0882239Tuscarawas Health Center of603 Monroe Street, Dover, OH 44622Certificate of waiverJan 30, 2028

National Provider Directory

National Provider Directory
Tax ID family
Aultman Orrville Hospital12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

211 Scio Rd SW
Carrollton, OH 44615
Phone (330) 627-0884

340 Oxford St
Ste 120
Dover, OH 44622
Phone (234) 801-2727

3250 Coral Rd NW
Malvern, OH 44644
Phone (330) 863-6114

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Robert Mullen Individual Corporate OfficerCeo Jul 1, 2024
Ryan S Jones Individual Corporate OfficerPresident Nov 1, 2022
Aultman Health Foundation Organization, Canton, OH Corporation, Non-profit 5% Or Greater Direct Ownership Interest Dec 1, 2020 100%
Adam Luntz Individual Corporate OfficerCfo Apr 1, 2016
Operational/Managerial ControlCfo Apr 1, 2016

Facilities with the same owner 14

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

View all 14

Practitioners & affiliated clinicians

Practitioners 34

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 34

NPI Registry JSON

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738540800000",
    "number": "1477150308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80690",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447080690",
            "telephone_number": "330-479-8705",
            "fax_number": "330-479-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 MONROE ST",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446222046",
            "telephone_number": "330-364-8889",
            "fax_number": "330-343-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORRVILLE HOSPITAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-05",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A",
        "authorized_official_last_name": "LUNTZ",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "330-363-3889"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tuscarawas Health Center of Aultman Orrville Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tuscarawas Health Center of Aultman Orrville Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dover, OH

Sources for this page

Verify at the official NPI Registry.