NPIMap

Organization Active NPI

Trinity Hospital Twin City

Doing business as Trinity Medical Group

  • Rural Health Clinic/Center
  • Newcomerstown, OH
National Provider Identifier
1790229284
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
TRINITY HOSPITAL TWIN CITY
Doing business as
Trinity Medical Group
Practice address
223 W Main St
Newcomerstown, OH 43832-1042
Phone
(740) 563-4435
Fax
(740) 498-1457
NPI assigned
Dec 19, 2016
Last updated
May 6, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
CATHOLIC HEALTH INITIATIVESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Authorized official

Name
Dwayne Richardson
Title
President
Phone
(740) 922-7450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X OH Primary

Addresses

Primary practice location

223 W Main St
Newcomerstown, OH 43832-1042

Mailing address

819 N 1St St
Dennison, OH 44621-1003
Phone (304) 210-4300

Other names 1

  • Trinity Medical Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170111000463 OH Part A Provider - Rural Health Clinic 6204004534 Practice locations: Newcomerstown, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790229284. Details of each certification follow.

Rural health clinic certification: CCN 363412

Legal name
TRINITY HOSPITAL TWIN CITY
Doing business as
TWIN CITY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 9, 2017
Last certification
Jun 9, 2017
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Mar 2, 2011 in OH
Enrollment address
223 W Main St
Newcomerstown, OH 43832-1042
Related CCNs
361302

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

Other NPIs with the same Medicare PAC ID 5

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2045301Trinity Medical Group Newcomerstown223 West Main St, Newcomerstown, OH 43832Certificate of waiverAug 8, 2026

National Provider Directory

National Provider Directory
Tax ID family
Trinity Hospital Twin City5 organizations share this tax ID, including this one
Part of
Catholic Health Initiatives

Other organizations with this tax ID 4

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

Locations

232 Cross St
Newcomerstown, OH 43832
Phone (330) 343-9600

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Jerry Simpson Individual Corporate DirectorBoard Member Aug 14, 2017
Dan Daily Individual Corporate DirectorBoard Member Aug 14, 2017
Commonspirit Health Organization, Englewood, CO Non-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2014 100%
Trinity Health System Organization, Steubenville, OH Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2017 100%
Matthew L Grimshaw Individual Corporate OfficerCeo Jul 31, 2017
Eric Exley Individual Corporate OfficerSecretary Aug 14, 2017
Dave Werkin Individual Corporate OfficerCfo Aug 14, 2017
John Lucey Individual Corporate DirectorMarket Director of Primary Care Jan 1, 2024
Karla Gregory-Martin Individual Corporate DirectorBoard Member Jul 1, 2021
James Padden Individual Corporate OfficerVice Chairperson Aug 14, 2017
Corporate DirectorBoard Member Jul 1, 2017
Dennis Wolters Individual Corporate DirectorBoard Member May 1, 2011
Larry P Schumacher Individual Corporate DirectorBoard Member Jul 1, 2021
Michael Biasi Individual Corporate DirectorBoard Member Aug 14, 2017
David Skiviat Individual Corporate DirectorTreasurer Jul 1, 2021
Samuel Licata Individual Corporate DirectorBoard Member Jul 1, 2021
Dwayne Richardson Individual Corporate OfficerPresident Mar 9, 2021
Aaron P Provenzano Individual Corporate DirectorChairman Jul 1, 2021
Karie Hunter Individual W-2 Managing EmployeePractice Coordinator Jan 1, 2024
Stuart K Brown Individual W-2 Managing EmployeeMedical Director Dec 8, 2016
Operational/Managerial ControlMedical Director Jan 28, 2013

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 9

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

NPI Registry JSON

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

{
    "created_epoch": "1482105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714953600000",
    "number": "1790229284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 N 1ST ST",
            "city": "DENNISON",
            "state": "OH",
            "postal_code": "446211003",
            "telephone_number": "304-210-4300",
            "fax_number": "740-283-7431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 W MAIN ST",
            "city": "NEWCOMERSTOWN",
            "state": "OH",
            "postal_code": "438321042",
            "telephone_number": "740-563-4435",
            "fax_number": "740-498-1457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY HOSPITAL TWIN CITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CATHOLIC HEALTH INITIATIVES",
        "enumeration_date": "2016-12-19",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "DWAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "740-922-7450"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newcomerstown, OH

Sources for this page

Verify at the official NPI Registry.