NPIMap

Organization Active NPI

Community Health & Wellness Partners of Logan County

  • Student Health Clinic/Center
  • Lewistown, OH
National Provider Identifier
1629791900
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
COMMUNITY HEALTH & WELLNESS PARTNERS OF LOGAN COUNTY
Practice address
8920 County Road 91 Ste 2
Lewistown, OH 43333-9786
Phone
(937) 599-1411
Fax
(937) 599-4128
NPI assigned
Sep 22, 2022
Organization subpart
Yes
Parent organization
COMMUNITY HEALTH AND WELLNESS PARTNERS OF LOGAN COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Authorized official

Name
Tara Dawn Bair
Title
Ceo
Phone
(937) 599-1411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

8920 County Road 91 Ste 2
Lewistown, OH 43333-9786

Mailing address

212 E Columbus Ave Ste 1
Bellefontaine, OH 43311-2033
Phone (937) 599-1411

Other names 1

  • Indian Lake School-Based Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140326001589 OH Part B Supplier - Clinic/Group Practice 8022247469 Receives reassigned benefits from 30 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West Liberty, OH; Urbana, OH; Saint Paris, OH; Russells Point, OH; De Graff, OH; Bellefontaine, OH; Lewistown, OH
O20240322002054 OH Part A Provider - Federally Qualified Health Center (FQHC) 8022247469 Practice locations: Lewistown, OH

Federally qualified health center certification: CCN 721136

Legal name
COMMUNITY HEALTH & WELLNESS PARTNERS OF LOGAN COUNTY
Doing business as
INDIAN LAKE SCHOOL-BASED HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 1, 2023
Last certification
Mar 1, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 6, 2012 in OH
Enrollment address
8920 County Road 91
Ste 2
Lewistown, OH 43333-9786

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Community Health Wellness Partners of Logan County17 organizations share this tax ID, including this one
Part of
Community Health Wellness Partners of Logan County

Other organizations with this tax ID 16

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

View all 16

Locations

6210 State Route 235 N
Ste 2
Lewistown, OH 43333

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
Kyle Springs Individual Corporate DirectorBoard of Directors Nov 2, 2017
Lydia Hess Individual Corporate DirectorDirector Jun 1, 2023
Becky Martin Individual Corporate DirectorDirector Mar 3, 2022
Jackie Prater Individual Corporate DirectorDirector May 5, 2022
Tara D Bair Individual Corporate OfficerCeo Jan 1, 2014
W-2 Managing EmployeeCeo Jan 1, 2014
Operational/Managerial ControlCeo Jan 1, 2014
Steven R Toney Individual Corporate DirectorMedical Director Jun 13, 2022
Kelli Bader Individual Corporate DirectorDirector Jun 2, 2022
Neil Rhodes Individual Corporate DirectorDirector Jun 2, 2022
Elizabeth McClure Individual Corporate DirectorSecretary Nov 2, 2017
Sarah Warren Individual Corporate DirectorDirector Mar 3, 2022
Mark Gibson Individual Corporate DirectorBoard of Directors Jul 11, 2019
Marcia Bailey Individual Corporate DirectorDirector Jun 1, 2023
Kyle Lentz Individual Corporate DirectorChair of Board Aug 1, 2019
Ryan Berry Individual Corporate DirectorDirector Apr 4, 2025
Le-Anne Fuson Individual Corporate DirectorDirector Jun 6, 2024

Owners & managing parties with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786665600000",
    "number": "1629791900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 E COLUMBUS AVE STE 1",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433112033",
            "telephone_number": "937-599-1411",
            "fax_number": "937-599-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8920 COUNTY ROAD 91 STE 2",
            "city": "LEWISTOWN",
            "state": "OH",
            "postal_code": "433339786",
            "telephone_number": "937-599-1411",
            "fax_number": "937-599-4128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH & WELLNESS PARTNERS OF LOGAN COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HEALTH AND WELLNESS PARTNERS OF LOGAN COUNTY",
        "enumeration_date": "2022-09-22",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A",
        "authorized_official_last_name": "BAIR",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "937-599-1411"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indian Lake School-Based Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Indian Lake School-Based Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lewistown, OH

Sources for this page

Verify at the official NPI Registry.