Otterbein Cridersville

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1959N Issued in OH

Legal business name

OTTERBEIN CRIDERSVILLE

Practice address

100 Red Oak Dr
Cridersville, OH 45806-9618

Phone

(419) 645-5114

Fax

(419) 645-7115

NPI assigned

Aug 22, 2005

Last updated

Jan 5, 2015By 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

Mrs. Rita C Hawkins

Title

Avp Finance/Controller

Phone

(513) 933-5401

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1710979141. Details of each certification follow.

• CCN 366050 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 366050

Legal name

OTTERBEIN CRIDERSVILLE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Mar 8, 1996

Last certification

Apr 23, 2025

Beds

50

Ownership / control type

Nonprofit Corporation

Multi-facility organization

Otterbein Senior Life

Organization structure

CorporationNon-profit

Incorporated

Feb 21, 2001 in OH

Enrollment address

100 Red Oak Dr
Cridersville, OH 45806-9618

Nursing home name

OTTERBEIN-CRIDERSVILLE

Affiliated entity

OTTERBEIN SENIORLIFE

Listed as

Otterbein-CridersvilleCCN 366050 · All quality measures

Overall star rating

3 of 5

Health inspections

3 of 5

Staffing

3 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Mar 8, 1996

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5044.6 residents per day on average

Chain

Otterbein Seniorlife20 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Otterbein Cridersville2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Otterbein Cridersville

  • Assisted Living Facility
  • Cridersville, OH
  • NPI 1437712841
  NPD tax ID

All disclosed owners & managing parties 34

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 2

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

• Salim W Hanna, M.D.

  • Family Medicine Physician
  • Lima, OH
  • NPI 1073555819

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Polaris Pharmacy Services of Ohio LLC

  • Long Term Care Pharmacy
  • Columbus, OH
  • NPI 1962271650

  Adp of the SNF

  CMS ownership

Facilities with the same owner 26

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

• Care at Home by Green Hills LLC

  dba Universal Home Health & Hospice

  • Home Health Agency
  • Bellefontaine, OH
  • NPI 1538222021

  Otterbein Home, Otterbein LSC, LLC

  CMS ownership
• Care at Home by Green Hills LLC

  dba Universal Home Health & Hospice

  • Community Based Hospice Care Agency
  • Bellefontaine, OH
  • NPI 1720142573

  Otterbein Home, Otterbein LSC, LLC

  CMS ownership
• North Shore Retirement Community

  dba Otterbein North Shore Retirement Living Community

  • Skilled Nursing Facility
  • Lakeside, OH
  • NPI 1760605000

  Functional Pathways of Tennessee LLC, Otterbein Home, Otterbein LSC, LLC

  CMS ownership
• Otterbein at Granville

  • Skilled Nursing Facility
  • Granville, OH
  • NPI 1003974023

  Functional Pathways of Tennessee LLC, Otterbein Home, Otterbein LSC, LLC

  CMS ownership
• Otterbein Batavia, LLC

  • Skilled Nursing Facility
  • Batavia, OH
  • NPI 1598131476

  Functional Pathways of Tennessee LLC, Otterbein Home

  CMS ownership
• Otterbein Clearcreek, LLC

  dba Avalon by Otterbein Clear Creek

  • Skilled Nursing Facility
  • Centerville, OH
  • NPI 1992977516

  Functional Pathways of Tennessee LLC, Otterbein Home

  CMS ownership
• Otterbein Gahanna, LLC

  • Skilled Nursing Facility
  • Gahanna, OH
  • NPI 1437548575

  Otterbein Home

  CMS ownership
• Otterbein Home Health, LLC

  dba Pioneer Home Health Agency

  • Home Health Agency
  • Lebanon, OH
  • NPI 1538178041

  Otterbein Home

  CMS ownership
• Otterbein Hospice LLC

  • Community Based Hospice Care Agency
  • Lebanon, OH
  • NPI 1548508062

  Otterbein Home

  CMS ownership
• Otterbein Lebanon

  • Skilled Nursing Facility
  • Lebanon, OH
  • NPI 1992797328

  Functional Pathways of Tennessee LLC, Otterbein Home, Otterbein LSC, LLC

  CMS ownership
• Otterbein Loveland, LLC

  • Skilled Nursing Facility
  • Loveland, OH
  • NPI 1780042622

  Functional Pathways of Tennessee LLC, Otterbein Home

  CMS ownership
• Otterbein Maineville, LLC

  dba Avalon by Otterbein at Maineville

  • Skilled Nursing Facility
  • Maineville, OH
  • NPI 1023337847

  Functional Pathways of Tennessee LLC, Otterbein Home

  CMS ownership

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Otterbein Cridersville

  • Assisted Living Facility
  • Cridersville, OH
  • NPI 1437712841
  NPPES parent name

Practitioners 1

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.

• Salim W Hanna, M.D.

  • Family Medicine Physician
  • Lima, OH
  • NPI 1073555819
  NPD (past)

Affiliated clinicians 4

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

• Salim W Hanna, M.D.

  • Family Medicine Physician
  • Lima, OH
  • NPI 1073555819

  Nursing home

  Care Compare affiliation
• Parmie A Herman, M.D.

  • Family Medicine Physician
  • Wapakoneta, OH
  • NPI 1053301614

  Nursing home

  Care Compare affiliation
• Mathew M Jose, MD

  • Family Medicine Physician
  • Wapakoneta, OH
  • NPI 1467429977

  Nursing home

  Care Compare affiliation
• Edward L Tremoulis, MD

  • Family Medicine Physician
  • Lima, OH
  • NPI 1376595728

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420416000000",
    "number": "1710979141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RED OAK DR",
            "city": "CRIDERSVILLE",
            "state": "OH",
            "postal_code": "458069618",
            "telephone_number": "419-645-5114",
            "fax_number": "419-645-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RED OAK DR",
            "city": "CRIDERSVILLE",
            "state": "OH",
            "postal_code": "458069618",
            "telephone_number": "419-645-5114",
            "fax_number": "419-645-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTTERBEIN CRIDERSVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-22",
        "last_updated": "2015-01-05",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "RITA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "AVP FINANCE/CONTROLLER",
        "authorized_official_telephone_number": "513-933-5401",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "1959N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "4488240001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0228088",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mishr Endocrinology & Diabetes Clinic LLC
• Suman K Mishr, MD
• Amber Dawn Neumeier
• Katherine Nichols-Singer
• Otterbein Cridersville
• Perry TWP Trustees
• Gloria Piehl
• Regina D Prenger
• Melisa Rahrig
• Schwieterman Village Pharmacy

• Skilled Nursing Facility in Cridersville, OH
• Providers in Cridersville, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; 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.