NPIMap

Organization Active NPI

Joint Township District Memorial Hospital

  • Skilled Nursing Facility
  • St Marys, OH
National Provider Identifier
1750345765
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL
Practice address
200 Saint Clair Ave
St Marys, OH 45885-2400
Phone
(419) 394-3335
Fax
(419) 394-8485
NPI assigned
Apr 14, 2006
Organization subpart
Yes
Parent organization
JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Authorized official

Name
Tricia Ann Pohl
Title
Cfo
Phone
(419) 394-3387

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

200 Saint Clair Ave
St Marys, OH 45885-2400

Mailing address

200 Saint Clair Ave
St Marys, OH 45885-2400
Phone (419) 394-3335

Other names 1

  • JTDMH Transitional Care Unit Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070319000041 OH Part A Provider - Skilled Nursing Facility 3870491590 Practice locations: Saint Marys, OH

Skilled nursing facility certification: CCN 365807

Legal name
JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL
Doing business as
GRAND LAKE PHYSICIAN PRACTICES
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Sep 17, 1990
Last certification
Aug 1, 2023
Beds
15
Ownership / control type
Other Nonprofit
Organization structure
CorporationNon-profit
Incorporated
Mar 10, 1989 in OH
Enrollment address
200 Saint Clair Ave
Saint Marys, OH 45885-2400
Nursing home name
TRANSITIONAL CARE UNIT

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Transitional Care UnitCCN 365807
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare
Ownership
Non profit - Other
Certified
Sep 17, 1990
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
154.0 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Joint Township District5 organizations share this tax ID, including this one
Part of
Joint Township District

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
JTD Hospital Foundation Organization, Saint Marys, OH Corporation, Non-profit Operational/Managerial Control Jan 1, 1990
Sara Vordermark Individual Operational/Managerial ControlTcu Administrator Apr 15, 2024
Adp of the SNF Apr 15, 2024
JTDM Family Practice LLC Organization, Saint Marys, OH LLC, Medical provider/supplier, For-profit Operational/Managerial Control Jan 1, 1990
Claudia Coe Individual Corporate DirectorMember Sep 1, 2017
Managing Control - Governing BodyMember Sep 1, 2017
Venkata Krishnarao Chalasani Individual Operational/Managerial Control Mar 1, 2013
Adp of the SNF Mar 1, 2013
Randall W. Niekamp Individual Corporate DirectorMember Jan 1, 2021
Managing Control - Governing BodyMember Jan 1, 2021
Connie H Meiring Individual Corporate DirectorBoard Member May 1, 2026
Managing Control - Governing BodyBoard Member May 1, 2026
Christopher John Stucke Individual Corporate DirectorMember Jan 1, 2024
Managing Control - Governing BodyMember Jan 1, 2024
Kenneth Lee Fox Individual Corporate DirectorMember Jan 1, 2020
Managing Control - Governing BodyMember Jan 1, 2020
Tricia a Pohl Individual Corporate OfficerChief Financial Officer Jan 3, 2022
Operational/Managerial Control Jan 3, 2022
Adp of the SNF Jan 3, 2022
Brian Schlosser Individual Corporate DirectorMember Jul 1, 2022
Managing Control - Governing BodyMember Jul 1, 2022
Hospital District of Jackson, German, Noble, and St. Marys Townships Organization, Saint Marys, OH Created for acquisition, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 1990 100%
Adp of the SNF Jul 15, 1990
Direct Ownership Interest Jan 1, 1990 100%
Jeffrey P. Squire Individual Corporate DirectorMember Jan 1, 2020
Managing Control - Governing BodyMember Jan 1, 2020
Michael J Boley Individual Corporate DirectorMember Jan 1, 2025
Managing Control - Governing BodyMember Jan 1, 2025
Wally B. Wagner Individual Corporate DirectorMember Jan 1, 2020
Managing Control - Governing BodyMember Jan 1, 2020
Cynthia Berning Individual Corporate OfficerPresident and Ceo Dec 16, 2020
Operational/Managerial Control Dec 16, 2020
Adp of the SNF Dec 16, 2020
Lana Hinders Individual Operational/Managerial Control May 3, 2019
Adp of the SNF May 3, 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 3

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

FacilityTypeRoleSince
Vancrest of St Mary'SSaint Marys, OH, CCN 365232 Skilled nursing facility 5% Or Greater Direct Ownership Interest (25%) Oct 16, 2019
Grand Lake Home HealthSaint Marys, OH, CCN 367405 Home health agency Operational/Managerial Control Jan 1, 1990
Grand Lake HospiceSt Marys, OH, CCN 361636 Hospice Operational/Managerial Control (100%) Oct 18, 2006

Owned or controlled facilities with NPI records 3

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

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 39

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 39

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707177600000",
    "number": "1750345765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SAINT CLAIR AVE",
            "city": "ST MARYS",
            "state": "OH",
            "postal_code": "458852400",
            "telephone_number": "419-394-3335",
            "fax_number": "419-394-8485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SAINT CLAIR AVE",
            "city": "ST MARYS",
            "state": "OH",
            "postal_code": "458852400",
            "telephone_number": "419-394-3335",
            "fax_number": "419-394-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL",
        "enumeration_date": "2006-04-14",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A",
        "authorized_official_last_name": "POHL",
        "authorized_official_first_name": "TRICIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "419-394-3387"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JTDMH Transitional Care Unit",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "JTDMH Transitional Care Unit",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in St Marys, OH

Sources for this page

Verify at the official NPI Registry.