NPIMap

Organization Active NPI

Orrville Hospital Foundation

Doing business as Aultman Orrville Doylestown Health Center

  • Rural Health Clinic/Center
  • Doylestown, OH
National Provider Identifier
1487226189
Registry record updated Oct 12, 2022
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
Aultman Orrville Doylestown Health Center
Practice address
400 Collier Dr Ste C
Doylestown, OH 44230-9757
Phone
(330) 684-2015
Fax
(330) 684-2075
NPI assigned
Jul 13, 2021
Last updated
Oct 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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 Primary

Addresses

Primary practice location

400 Collier Dr Ste C
Doylestown, OH 44230-9757

Mailing address

PO Box 80690
Canton, OH 44708-0690
Phone (330) 363-7444

Other names 1

  • Aultman Orrville Doylestown Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221201000578 OH Part A Provider - Rural Health Clinic 7911890546 Practice locations: Doylestown, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487226189. Details of each certification follow.

Rural health clinic certification: CCN 363436

Legal name
ORRVILLE HOSPITAL FOUNDATION
Doing business as
AULTMAN ORRVILLE DOYLESTOWN HEALTH CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 28, 2022
Last certification
Dec 28, 2022
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Dec 26, 1985 in OH
Enrollment address
400 Collier Dr
Ste C
Doylestown, OH 44230-9757
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
36D2241212Aultman Orrville Doylestown Health400 Collier Drive, Suite C, Doylestown, OH 44230Certificate of waiverOct 25, 2027

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

1020 Trump Rd NW
Ste 4
Carrollton, OH 44615
Phone (330) 627-0884

Interoperability endpoints

  • Direct secure messaging: michael.halko@direct.aultman.org

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
Aultman Health Foundation Organization, Canton, OH Corporation, Non-profit 5% Or Greater Direct Ownership Interest Dec 20, 2011 100%
Amelia E Laing Individual Corporate DirectorBoard Member Secretary Jan 1, 2018 25%
Adam Luntz Individual Corporate OfficerCfo Apr 1, 2016
Sarah Schroeder Individual W-2 Managing EmployeeDirector of Payer Relations May 1, 2019 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 14

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

View all 14

Practitioners & affiliated clinicians

Practitioners 9

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": "1626134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665532800000",
    "number": "1487226189",
    "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": "330-363-7444",
            "fax_number": "330-363-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 COLLIER DR STE C",
            "city": "DOYLESTOWN",
            "state": "OH",
            "postal_code": "442309757",
            "telephone_number": "330-684-2015",
            "fax_number": "330-684-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORRVILLE HOSPITAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-13",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aultman Orrville Doylestown Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Doylestown, OH

Sources for this page

Verify at the official NPI Registry.