NPIMap

Organization Active NPI

Defiance Hospital Inc.

Doing business as Defiance Regional Medical Center

  • Critical Access Hospital
  • Defiance, OH
National Provider Identifier
1699775726
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
1160 Issued in OH
Legal business name
DEFIANCE HOSPITAL INC.
Doing business as
Defiance Regional Medical Center
Practice address
1200 Ralston Ave
Defiance, OH 43512-1396
Phone
(800) 477-4035
Fax
(419) 882-1352
NPI assigned
Jul 29, 2005
Last updated
Dec 22, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
PROMEDICA HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Authorized official

Name
Kevin Sharp
Title
VP Rev Cycle
Phone
(675) 857-5765

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 1160 OH Primary

Addresses

Primary practice location

1200 Ralston Ave
Defiance, OH 43512-1396

Mailing address

PO Box 632927
Cincinnati, OH 45263-2927
Phone (800) 477-4035

Other identifiers 1

IdentifierTypeStateIssuer
2079503MedicaidOH

Other names 1

  • Defiance Regional Medical 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
O20040322000150 OH Part B Supplier - Clinic/Group Practice 6305754557 Receives reassigned benefits from 11 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Defiance, OH
O20090922000062 OH Part A Provider - Critical Access Hospital 6305754557 Practice locations: Defiance, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699775726. Details of each certification follow.

Hospital certification: CCN 361328

Legal name
DEFIANCE HOSPITAL INC.
Doing business as
DEFIANCE REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Feb 1, 2005
Last certification
Jan 7, 2005
Beds
35
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1998 in OH
Enrollment address
1200 Ralston Ave
Defiance, OH 43512-1396
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Promedica Defiance Regional HospitalCCN 361328 · All quality measures
Overall star rating
5 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Defiance Hospital14 organizations share this tax ID, including this one
Part of
Promedica Health System

Other organizations with this tax ID 13

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

View all 13

Ownership & related parties

All disclosed owners & managing parties 23

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

NameRoleSinceShare
Kevin Sharp Individual Corporate OfficerVP Revenue Cycle Mar 1, 2020
Cynthia Ensign Individual Corporate DirectorBoard of Director Jan 22, 2022
Jennier Boyd Individual Corporate DirectorBoard Member Jan 22, 2019
Jordan W Stuckey Individual Corporate DirectorBoard Member Jan 22, 2019
Holly Bristoll Individual Corporate DirectorBoard Member May 9, 2019
Douglas J Bush Individual Corporate DirectorBoard Member Jan 22, 2019
Jonathan Gathman Individual Corporate DirectorBoard of Director Jan 22, 2022
Kathryn Groff Individual Corporate DirectorBoard Member Jan 22, 2019
Joshua Lucas Individual Corporate DirectorBoard Member Jan 22, 2019
Crystal Hornish Individual Corporate DirectorBoard Member Jan 22, 2019
Christina Stansfield Individual Operational/Managerial ControlDirector Acute Care Billing Sep 1, 2020
Amer Arshad Individual Corporate DirectorBoard of Director Jan 19, 2022
Robert Morton Individual Corporate DirectorBoard of Director Jan 22, 2022
Laura W Kline Individual Corporate DirectorBoard Member Mar 20, 2013
Richanne Mankey Individual Corporate DirectorBoard Member Jan 22, 2019
Dawn Buskey Individual Corporate DirectorBoard Member Feb 11, 2021
Diana Eichenauer Individual Operational/Managerial ControlManager Mar 2, 2020
Michelle Stahl Individual Corporate DirectorBoard Member Jan 22, 2019
Sue Strausbaugh Individual Corporate DirectorBoard Member Jan 22, 2019
Gary Cates Individual Corporate DirectorBoard Member Jan 22, 2019
Samuel Switzer Individual Corporate DirectorBoard of Director Feb 22, 2022
Arturo Polizzi Individual Corporate OfficerCeo May 24, 2022
Promedica Health System Inc Organization, Toledo, OH Non-profit Operational/Managerial Control Jan 1, 2015

Owners & managing parties with NPI records 3

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

Facilities with the same owner 15

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

View all 15

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 14

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 14

Affiliated clinicians 154

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 154

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703203200000",
    "number": "1699775726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632927",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632927",
            "telephone_number": "800-477-4035",
            "fax_number": "419-882-1352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 RALSTON AVE",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435121396",
            "telephone_number": "800-477-4035",
            "fax_number": "419-882-1352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEFIANCE HOSPITAL INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROMEDICA HEALTH SYSTEM",
        "enumeration_date": "2005-07-29",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A",
        "authorized_official_last_name": "SHARP",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "VP REV CYCLE",
        "authorized_official_telephone_number": "675-857-5765"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "OH",
            "license": "1160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2079503",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Defiance Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Defiance Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Defiance, OH

Sources for this page

Verify at the official NPI Registry.