NPIMap

Organization Active NPI

Fairfield Medical Center

  • Rural Health Clinic/Center
  • New Lexington, OH
National Provider Identifier
1699496745
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
FAIRFIELD MEDICAL CENTER
Practice address
775 Carroll St
New Lexington, OH 43764-9415
Phone
(740) 343-4447
NPI assigned
Sep 7, 2022
Last updated
Sep 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Authorized official

Name
Jack R Janoso Jr.
Title
President and Ceo
Phone
(740) 687-8000

Specialties & licenses 1

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

Addresses

Primary practice location

775 Carroll St
New Lexington, OH 43764-9415

Mailing address

401 N Ewing St
Lancaster, OH 43130-3372
Phone (740) 687-8000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221117002657 OH Part A Provider - Rural Health Clinic 8123013786 Practice locations: New Lexington, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699496745. Details of each certification follow.

Rural health clinic certification: CCN 363443

Legal name
FAIRFIELD MEDICAL CENTER
Doing business as
PRIMARY CARE NEW LEXINGTON
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 23, 2023
Last certification
Oct 23, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
775 Carroll St
New Lexington, OH 43764-9415
Related CCNs
360072

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

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Fairfield Medical Cente3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1143 E Main St
Lancaster, OH 43130
Phone (740) 687-8602

1203 Riv Vly Blvd
Ste B
Lancaster, OH 43130
Phone (740) 687-5971

135 N Ewing St
Ste 303
Lancaster, OH 43130
Phone (740) 687-8805

1550 Sheridan Dr
#302
Lancaster, OH 43130
Phone (740) 689-6420

775 Carroll St
New Lexington, OH 43764
Phone (740) 343-0341

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
Mark Vanderhoff Individual Corporate OfficerChief Nursing Officer Dec 14, 2020
Alan Greenslade Individual Corporate OfficerChief Administrative Officer Sep 17, 2020
Daniel J Fruth Individual Corporate DirectorBoard Member Aug 27, 2020
Laura Tussing Individual Corporate DirectorBoard Member Jun 1, 2018
Jonathan C Kelly Individual Corporate OfficerChief Financial Officer Feb 15, 2021
Natalie Furniss Individual Corporate DirectorBoard Member Jun 1, 2022
Michael Lieber Individual Corporate DirectorBoard Member Jul 13, 2022
Mark T Darnell Individual Corporate OfficerChief Medical Officer Feb 1, 2021
Marie Ward Individual Corporate DirectorBoard Member Aug 1, 2021
Melony Rarick Individual Corporate OfficerCorporate Compliance Officer Oct 27, 2019
Stephen Swick Individual Corporate DirectorBoard Member Jun 1, 2021
John Janoso Individual Corporate OfficerPresident and Ceo Oct 13, 2014
Laurianne F Scott Individual Corporate DirectorBoard Member Jun 1, 2018
Pamela Starlin Individual Corporate DirectorDirector of Facility Operations May 1, 2012
W-2 Managing Employee May 1, 2012
Angela Krile Individual Corporate DirectorBoard Member Jun 1, 2016
Theresa Anne Dyar Individual Corporate DirectorBoard Member Oct 1, 2017
Laura Moore Individual Corporate OfficerChief Business and Strategy Officer Jul 11, 2016
Bradley a Hedges Individual Corporate DirectorBoard Member, Chair Aug 27, 2020
Ron Burris Individual Corporate DirectorBoard Member Jun 1, 2021
Laurie Lach Individual Corporate DirectorBoard Member Aug 1, 2021
Ronald P Linehan Individual Corporate DirectorBoard Member Feb 28, 2018
Matthew Wideman Individual Corporate DirectorBoard Member Jun 1, 2019

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Diley Ridge Medical CenterCanal Winchester, OH, CCN 360358 Hospital 5% Or Greater Direct Ownership Interest (30%) Dec 9, 2003

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 67

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.

View all 67

NPI Registry JSON

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662508800000",
    "number": "1699496745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N EWING ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303372",
            "telephone_number": "740-687-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 CARROLL ST",
            "city": "NEW LEXINGTON",
            "state": "OH",
            "postal_code": "437649415",
            "telephone_number": "740-343-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFIELD MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A",
        "authorized_official_last_name": "JANOSO",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "740-687-8000",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lexington, OH

Sources for this page

Verify at the official NPI Registry.