Shriners Hospitals for Children

Primary specialty

Children's HospitalTaxonomy code 282NC2000X

License

1808 Issued in OH

Legal business name

SHRINERS HOSPITALS FOR CHILDREN

Doing business as

Shriners Children's Ohio

Practice address

1 Children's Plaza
2 West
Dayton, OH 45404-1815

Phone

(513) 872-6000

Fax

(513) 872-6025

NPI assigned

Apr 25, 2007

Last updated

Feb 5, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jerry G. Gantt

Title

President

Phone

(813) 281-0300

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shriners Children's Ohio Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659590644. Details of each certification follow.

• CCN 363308 Hospital · Active · Details

Hospital certification: CCN 363308

Legal name

SHRINERS HOSPITALS FOR CHILDREN

Doing business as

SHRINERS CHILDREN'S OHIO

Certification status

Active

Provider type (POS)

Hospital – Children’s

Participating since

May 13, 2011

Last certification

May 13, 2011

Beds

30

Ownership / control type

Private (not for profit)

Organization structure

CorporationNon-profit

Incorporated

Jun 18, 1925 in CO

Enrollment address

1 Children's Plaza
2 West
Dayton, OH 45404-1815
Other Hospital Practice Location

Hospital subgroups

Children’s

Listed as

Shriners Hospitals for ChildrenCCN 363308 · All quality measures

Type

Childrens

Ownership

Voluntary non-profit - Private

Medicare certification status

ActiveFrom the Provider of Services file

Emergency services

No

Locations

All disclosed owners & managing parties 25

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

Owners & managing parties with NPI records 1

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

• Leslie Douglas Stewart, MD

  • Surgery Physician
  • Memphis, TN
  • NPI 1902874282

  Corporate Director, Corporate Officer

  CMS ownership

All facility ownership & control disclosures 8

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

Facilities with the same owner 8

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

• Shriners Hospitals for Children

  • Children's Hospital
  • Honolulu, HI
  • NPI 1316065360

  Shriners Hospitals for Children

  CMS ownership
• Shriners Hospitals for Children

  • Children's Hospital
  • Greenville, SC
  • NPI 1326187097

  Shriners Hospitals for Children

  CMS ownership
• Shriners Hospitals for Children

  • Children's Hospital
  • Chicago, IL
  • NPI 1376656538

  Shriners Hospitals for Children

  CMS ownership
• Shriners Hospitals for Children

  • Children's Hospital
  • Philadelphia, PA
  • NPI 1558404632

  Shriners Hospitals for Children

  CMS ownership
• Shriners Hospitals for Children

  • Children's Hospital
  • Galveston, TX
  • NPI 1669513941

  Shriners Hospitals for Children

  CMS ownership
• Shriners Hospitals for Children

  • Children's Hospital
  • Saint Louis, MO
  • NPI 1942343447

  Shriners Hospitals for Children

  CMS ownership
• Shriners Hospitals for Children

  • Children's Hospital
  • Sacramento, CA
  • NPI 1962530451

  Shriners Hospitals for Children

  CMS ownership
• Shriners Hospitals for Children

  • Children's Hospital
  • Portland, OR
  • NPI 1982793139

  Shriners Hospitals for Children

  CMS ownership

Practitioners 2

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.

• Alice Marie Fagin, MD

  • Surgery Physician
  • Little Rock, AR
  • NPI 1194995837
  NPD (past)
• Sara Marie Higginson, M.D.

  • Surgical Critical Care Physician
  • Fresno, CA
  • NPI 1578852471
  NPD (past)

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612483200000",
    "number": "1659590644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500",
            "address_2": "LOCKBOX #7642",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191787642",
            "telephone_number": "813-281-8478",
            "fax_number": "813-281-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDREN'S PLAZA",
            "address_2": "2 WEST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041815",
            "telephone_number": "513-872-6000",
            "fax_number": "513-872-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHRINERS HOSPITALS FOR CHILDREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A",
        "authorized_official_last_name": "GANTT",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-281-0300"
    },
    "taxonomies": [
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": "OH",
            "license": "1808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO DEPT OF HEALTH",
            "identifier": "1808",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shriners Children's Ohio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Yvonne Shows
• Ruby Shrestha, M.D
• Emily Renee Shrider
• Shriners Hospitals for Children
• Shriners Hospitals for Children
• Mohammed A. Shrit, MD
• Kaustubh Kailash Shrivastava, M.D
• Terry Monique Shrivers
• Emilee K Shroyer, MSN, APRN, FNP-C
• Sonya Shull, PT

• Children's Hospital in Dayton, OH
• Providers in Dayton, OH by specialty
• Children's Hospital in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.