NPIMap

Organization Active NPI

Hopewell Health Centers Inc

  • Family Medicine Physician
  • Coolville, OH
National Provider Identifier
1770929762
Registry record updated Oct 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HOPEWELL HEALTH CENTERS INC
Practice address
25716 Wilson St
Coolville, OH 45723-8153
Phone
(740) 773-4366
NPI assigned
May 16, 2013
Last updated
Oct 2, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2013

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

Authorized official

Name
Mark Bridenbaugh
Title
Ceo
Phone
(740) 773-4366

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OH Primary

Addresses

Primary practice location

25716 Wilson St
Coolville, OH 45723-8153

Mailing address

1049 Western Ave
PO Box 188
Chillicothe, OH 45601-1104
Phone (740) 773-4366

Other names 1

  • Family Healthcare Inc Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140115000006 OH Part A Provider - Federally Qualified Health Center (FQHC) 9234049990 Practice locations: Coolville, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770929762. Details of each certification follow.

Federally qualified health center certification: CCN 361041

Legal name
HOPEWELL HEALTH CENTERS, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 15, 2014
Last certification
Jan 15, 2014
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Aug 29, 1985 in OH
Enrollment address
25716 Wilson St
Coolville, OH 45723-8153

National Provider Directory

National Provider Directory
Tax ID family
Hopewell Health Centers Inc72 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Mark a. Bridenbaugh Individual Corporate OfficerChief Executive Officer Nov 1, 2000 100%
Donald Poole Individual Corporate DirectorMember Board of Directors Feb 1, 2011
Nicole White Individual W-2 Managing Employee Oct 1, 2014
Walter Goble Individual Corporate DirectorMember of Board of Directors May 1, 2013
Rosemary Hayes Individual Corporate DirectorMember of Board of Directors Jul 1, 2013
Wendy Porter Individual Corporate DirectorMember of Board of Directors Jul 1, 2013
Kathryn Cecil Individual Corporate DirectorVice President Board of Directors Mar 30, 2004
Thomas R. McGuire Individual Corporate DirectorMember of Board of Directors Aug 1, 1999
Dawn Murray Individual Corporate DirectorMedical Director Apr 1, 2001

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Hopewell Health Centers, Inc.Pomeroy, OH, CCN 361921 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 9, 2013
Hopewell Health Centers, Inc.Reedsville, OH, CCN 721871 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 9, 2013
Hopewell Health Centers, Inc.Racine, OH, CCN 721930 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 9, 2013
Hopewell Health Centers IncMarietta, OH, CCN 721137 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 9, 2013
Hopewell Health Centers, Inc.Beverly, OH, CCN D21090 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 9, 2013

NPI Registry JSON

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

{
    "created_epoch": "1368662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380672000000",
    "number": "1770929762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1049 WESTERN AVE",
            "address_2": "PO BOX 188",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456011104",
            "telephone_number": "740-773-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25716 WILSON ST",
            "city": "COOLVILLE",
            "state": "OH",
            "postal_code": "457238153",
            "telephone_number": "740-773-4366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOPEWELL HEALTH CENTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-16",
        "last_updated": "2013-10-02",
        "status": "A",
        "authorized_official_last_name": "BRIDENBAUGH",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "740-773-4366"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Healthcare Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Coolville, OH

Sources for this page

Verify at the official NPI Registry.