NPIMap

Organization Active NPI

Orrville Hospital Foundation

Doing business as Dunlap Family Physicians

  • Rural Health Clinic/Center
  • Orrville, OH
National Provider Identifier
1609231307
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
Dunlap Family Physicians
Practice address
830 S Main St
Orrville, OH 44667-2291
Phone
(330) 684-2015
Fax
(330) 684-2075
NPI assigned
Dec 22, 2015
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
Matthew Stewart
Title
Cfo
Phone
(330) 684-4763

Specialties & licenses 1

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

Addresses

Primary practice location

830 S Main St
Orrville, OH 44667-2291

Mailing address

830 S Main St
Orrville, OH 44667-2291
Phone (330) 684-2015

Other names 1

  • Dunlap Family Physicians Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160229000804 OH Part A Provider - Rural Health Clinic 7911890546 Practice locations: Orrville, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609231307. Details of each certification follow.

Rural health clinic certification: CCN 363404

Legal name
ORRVILLE HOSPITAL FOUNDATION
Doing business as
AULTMAN ORRVILLE DUNLAP FAMILY PHYSICIANS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 6, 2016
Last certification
Sep 6, 2016
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Dec 26, 1985 in OH
Enrollment address
830 S Main St
Ste 5-11
Orrville, OH 44667-2291
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
36D0342804Aultman Orrville Dunlap Family830 S Main Street, Suite 5-11, Orrville, OH 44667Certificate of waiverMar 19, 2027

National Provider Directory

National Provider Directory
Tax ID family
Orrville Hospital Foundation12 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.

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
Mark Auble Individual Corporate OfficerBoard Chairperson Jan 1, 2012 7.69%
Thomas S Gregory Individual Corporate OfficerBoard Treasurer Jan 1, 2012 7.69%
Becky Jewell Individual Corporate DirectorBoard Member Jan 1, 2012 7.69%
Jeffrey B Miller Individual Corporate DirectorBoard Member Jan 1, 2012 7.69%
Beth Theibert Individual W-2 Managing EmployeeOn-Site Managing Employee Dec 5, 1985 100%
Alfred Schiaback Individual Corporate DirectorBoard Member Jan 1, 2012 7.69%
Douglas Sibila Individual Corporate OfficerBoard Secretary Jan 1, 2012 7.69%
Ryan S Jones Individual Corporate OfficerBoard Member, Ceo Aoh Aug 1, 2017 7.69%
Corporate DirectorBoard Member, Ceo Aoh Aug 1, 2017 7.69%
Edward Roth Individual Corporate OfficerCeo of Aultman Health Foundation Jan 1, 2012 7.69%
Aultman Health Foundation Organization, Canton, OH Non-profit 5% Or Greater Direct Ownership Interest Dec 20, 2011 100%
Paul J Crowley Individual Corporate DirectorBoard Member, Medical Staff Preside Jan 1, 2016 7.69%
Diane Jarrett Individual Corporate DirectorBoard Member Jan 28, 2016 7.69%
George Lemon Individual Corporate DirectorBoard Member Jan 1, 2012 7.69%
Andrew J Naumoff Individual Corporate OfficerBoard Vice Chairperson Jan 1, 2014 7.69%
Adam Luntz Individual Corporate OfficerChief Financial Officer Apr 1, 2016 7.69%
Operational/Managerial ControlChief Financial Officer Apr 1, 2016

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

NPI Registry JSON

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738540800000",
    "number": "1609231307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 S MAIN ST",
            "city": "ORRVILLE",
            "state": "OH",
            "postal_code": "446672291",
            "telephone_number": "330-684-2015",
            "fax_number": "330-684-2075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S MAIN ST",
            "city": "ORRVILLE",
            "state": "OH",
            "postal_code": "446672291",
            "telephone_number": "330-684-2015",
            "fax_number": "330-684-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORRVILLE HOSPITAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-22",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "330-684-4763"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dunlap Family Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orrville, OH

Sources for this page

Verify at the official NPI Registry.