Active NPI
Paulding County Hospital
- Medicare Defined Swing Bed Hospital Unit
- Paulding, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medicare Defined Swing Bed Hospital Unit
- License
- 275N00000X
- Legal business name
- PAULDING COUNTY HOSPITAL
- Practice address
- 1035 W Wayne St
Paulding, OH 45879-1544 - Phone
- (419) 399-4080
- Fax
- (419) 399-1147
- NPI assigned
- Mar 14, 2006
- Last updated
- Jan 11, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ronald H Goedde
- Title
- Ceo
- Phone
- (419) 399-1103
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | 275N00000X | OH | Primary |
Addresses
Primary practice location
1035 W Wayne St
Paulding, OH 45879-1544
Mailing address
1035 W Wayne St
Paulding, OH 45879-1544
Phone (419) 399-4080
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081119000484 | OH | Part A Provider - Critical Access Hospital | 1153303532 | Practice locations: Paulding, OH |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1760450951. Details of each certification follow.
Hospital certification: CCN 36Z300
- Legal name
- PAULDING COUNTY HOSPITAL
- Organization structure
- Other
- Enrollment address
- 1035W Wayne St
Paulding, OH 45879-1544
Related certifications (CCN) 1
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
- Paulding County Hos DME
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Critical Access Hospital
- Paulding, OH
- NPI 1144298514
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Ownership & related parties
All disclosed owners & managing parties 11
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Andrew Wannemacher | Corporate Officer | Mar 1, 2020 | |
| Jeanise Denning | W-2 Managing Employee | Nov 4, 2014 | |
| Ann Pease | Corporate Director | Nov 5, 2008 | |
| John Kobee | Corporate Director | Mar 1, 2013 | |
| Ronald Goedde | Operational/Managerial Control | Jan 9, 2019 | 10% |
| Kyle Mawer | Corporate Officer | Jun 3, 2014 | |
| W-2 Managing Employee | Jun 3, 2014 | ||
| Operational/Managerial Control | Jun 3, 2014 | ||
| Candice Elliott | Corporate Director | Mar 1, 2020 | |
| Konnie Gerber | Corporate Director | Nov 5, 2008 | |
| Beth Stoller | Corporate Director | Mar 1, 2022 | 10% |
| Jason Thornell | Corporate Director | Mar 1, 2022 | 10% |
| Paulding County | 5% Or Greater Direct Ownership Interest | Nov 4, 2014 | 100% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Public Health or Welfare Agency
- Paulding, OH
- NPI 1720056575
5% Or Greater Direct Ownership Interest
Practitioners & affiliated clinicians
Affiliated clinicians 3
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": "1142294400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1610323200000",
"number": "1760450951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1035 W WAYNE ST",
"city": "PAULDING",
"state": "OH",
"postal_code": "458791544",
"telephone_number": "419-399-4080",
"fax_number": "419-399-1147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1035 W WAYNE ST",
"city": "PAULDING",
"state": "OH",
"postal_code": "458791544",
"telephone_number": "419-399-4080",
"fax_number": "419-399-1147"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PAULDING COUNTY HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2006-03-14",
"last_updated": "2021-01-11",
"certification_date": "2021-01-11",
"status": "A",
"authorized_official_last_name": "GOEDDE",
"authorized_official_first_name": "RONALD",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "419-399-1103"
},
"taxonomies": [
{
"code": "275N00000X",
"taxonomy_group": "",
"desc": "Medicare Defined Swing Bed Unit",
"state": "OH",
"license": "275N00000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paulding, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.