NPIMap

Organization Active NPI

Galion Community Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Galion, OH
National Provider Identifier
1487734984
Registry record updated Apr 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
1132 Issued in OH
Legal business name
GALION COMMUNITY HOSPITAL
Practice address
269 Portland Way S
Galion, OH 44833-2312
Phone
(419) 468-4841
Fax
(419) 468-8579
NPI assigned
Oct 17, 2006
Last updated
Apr 7, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
GALION COMMUNITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 7, 2014

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

Authorized official

Name
Donald Eric Draime
Title
Cfo
Phone
(419) 468-0501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 1132 OH Primary

Addresses

Primary practice location

269 Portland Way S
Galion, OH 44833-2312

Mailing address

269 Portland Way S
Galion, OH 44833-2312
Phone (419) 468-4841

Other identifiers 3

IdentifierTypeStateIssuer
GA3601941OtherOHMEDICARE PART B
000000157580OtherOHANTHEM
3031507MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071121000560 OH Part A Provider - Critical Access Hospital 5496737439 Practice locations: Galion, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487734984. Details of each certification follow.

Hospital certification: CCN 36Z325

Legal name
GALION COMMUNITY HOSPITAL
Doing business as
GALION COMMUNITY HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Nov 5, 1954 in OH
Enrollment address
269 Portland Way S
Galion, OH 44833-2312

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

Other NPIs with the same Medicare PAC ID 16

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

View all 16

National Provider Directory

National Provider Directory
Tax ID family
James a Goudy II MD27 organizations share this tax ID, including this one
Part of
James a Goudy II MD

Other organizations with this tax ID 26

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

View all 26

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
Jeffrey Underwood Individual Corporate DirectorBoard Member Jan 30, 2014
Mark Schneider Individual Corporate DirectorBoard Member Aug 30, 2007
Linda Chambers Individual Corporate DirectorBoard Member Jan 1, 2000
Kymberly Fox Individual Corporate DirectorBoard Member Aug 30, 2001
Kay E McDonald Individual Corporate DirectorBoard Member Jan 28, 2010
Linda Smith Individual Corporate DirectorBoard Member Jan 30, 2004
Rex Cramer Individual Corporate DirectorBoard Member Jan 25, 2007
Jerome B Morasko Individual Corporate OfficerCeo/ Managerial Apr 13, 2009
W-2 Managing EmployeeCeo/ Managerial Apr 13, 2009
Philip M Brown Individual Corporate DirectorBoard Member Jan 28, 2010
Joseph Shadeed Individual Corporate DirectorBoard Member Jan 27, 2011
Donald E Draime Individual Corporate OfficerCfo Mar 29, 2010
W-2 Managing Employee Mar 29, 2010
Sherri L Clevenger Individual Corporate DirectorBoard Member Jan 28, 2010
Douglas Schilling Individual Corporate DirectorBoard Member Jan 25, 2007
Jason R McMullen Individual Corporate DirectorBoard Member Jan 27, 2011
Donald Plotts Individual Corporate DirectorBoard Member Jan 30, 2014

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Bucyrus Community HospitalBucyrus, OH, CCN 361316 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 31, 2010
Avita OntarioOntario, OH, CCN 360365 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 8, 2015
GCH Physician Practice Gaius StreetBucyrus, OH, CCN 363411 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 5, 1954

Owned or controlled facilities with NPI records 3

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

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396828800000",
    "number": "1487734984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 PORTLAND WAY S",
            "city": "GALION",
            "state": "OH",
            "postal_code": "448332312",
            "telephone_number": "419-468-4841",
            "fax_number": "419-468-2381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 PORTLAND WAY S",
            "city": "GALION",
            "state": "OH",
            "postal_code": "448332312",
            "telephone_number": "419-468-4841",
            "fax_number": "419-468-8579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALION COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GALION COMMUNITY HOSPITAL",
        "enumeration_date": "2006-10-17",
        "last_updated": "2014-04-07",
        "status": "A",
        "authorized_official_last_name": "DRAIME",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "419-468-0501"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "OH",
            "license": "1132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "GA3601941",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000157580",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3031507",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galion, OH

Sources for this page

Verify at the official NPI Registry.