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Organization Active NPI

Glenbeigh

Doing business as Glenbeigh Health Sources

  • Special Hospital
  • Rock Creek, OH
National Provider Identifier
1790761922
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Special HospitalTaxonomy code 284300000X
License
6713 Issued in OH
Legal business name
GLENBEIGH
Doing business as
Glenbeigh Health Sources
Practice address
2863 State Route 45 N
P O Bo 298
Rock Creek, OH 44084-9352
Phone
(440) 563-3400
Fax
(440) 563-9363
NPI assigned
Dec 20, 2005
Last updated
Jul 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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

Authorized official

Name
Emily Wood
Title
Director PFS
Phone
(440) 997-6622

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Special Hospital 284300000X 6713 OH Primary

Addresses

Primary practice location

2863 State Route 45 N
P O Bo 298
Rock Creek, OH 44084-9352

Mailing address

2863 State Route 45 N
P.O. Box 298
Rock Creek, OH 44084-9352
Phone (440) 563-3400

Other practice location 1

20220 Center Ridge Rd Ste 110
Rocky River, OH 44116-3501
Phone (440) 356-7620

Other practice location 2

29 North Rd
Niles, OH 44446-1918
Phone (330) 652-6770

Other practice location 3

4661 Belpar St NW
Canton, OH 44718-3602
Phone (330) 492-2600

Other practice location 4

3526 Peach St
Erie, PA 16508-2742
Phone (814) 864-4226

Other practice location 5

3789 Green Rd Ste B
Beachwood, OH 44122-5708
Phone (216) 464-5800

Other names 1

  • GLENBEIGH HEALTH SOURCES Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040706000151 OH Part B Supplier - Clinic/Group Practice 8820075104 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rock Creek, OH
O20080822000169 OH Part A Provider - Hospital 8820075104 Practice locations: Rock Creek, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790761922. Details of each certification follow.

Hospital certification: CCN 360245

Legal name
GLENBEIGH
Doing business as
ASHTABULA REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Apr 1, 1992
Last certification
Jun 13, 2024
Beds
114
Ownership / control type
Private (for profit)
Organization structure
CorporationNon-profit
Incorporated
Jan 9, 1995 in OH
Enrollment address
2863 State Route 45 N
Rock Creek, OH 44084-9352
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs with the same Medicare PAC ID 1

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

  • Glenbeigh
    • Addiction (Substance Use Disorder) Psychologist
    • Rock Creek, OH
    • NPI 1831935857

    8820075104

    Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

  • Glenbeigh
    • Addiction (Substance Use Disorder) Psychologist
    • Rock Creek, OH
    • NPI 1831935857

    O20040706000151

    Same enrollment

Care Compare: Hospital

Medicare Care Compare
Listed as
Glenbeigh Health SourcesCCN 360245 · All quality measures
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Ashtabula County Medica9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3789 Green Rd
Ste B
Beachwood, OH 44122
Phone (216) 464-5800

4661 Belpar St NW
Canton, OH 44718
Phone (330) 492-2600

29 North Rd
Niles, OH 44446
Phone (330) 652-6770

20220 Center Ridge Rd
Ste 110
Rocky River, OH 44116
Phone (440) 356-7620

3425 Executive Pkwy
Ste 207
Toledo, OH 43606
Phone (419) 536-4000

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Katherine Hancock Individual Corporate DirectorBoard Member Jan 1, 2019
Craig Sernik Individual Corporate DirectorBoard Member Jan 1, 2019
Nancy Kister Individual Corporate DirectorBoard Member Jan 1, 2015
Emily Wood Individual W-2 Managing EmployeeDirector PFS Sep 28, 2019
Donald Chaplin Individual Corporate Director Jan 1, 2024
Ashtabula County Medical Center Organization, Ashtabula, OH Non-profit Operational/Managerial Control Apr 1, 1992 100%
James Timonere Individual Corporate DirectorBoard Member Jan 1, 2015
Shinoj Pattali Jayavalsan Individual Corporate OfficerVice Chief of Staff Feb 1, 2025
W-2 Managing EmployeeVice Chief of Staff Feb 1, 2025
Jospeh Giangola Individual Corporate DirectorBoard Member Jan 1, 2015
Alanna Dames Individual Corporate Officer Jan 1, 2023
Brian Jeffrey Harte Individual Corporate OfficerBoard Member Feb 1, 2025
David J Novak Individual W-2 Managing EmployeeChief of Staff Feb 1, 2025
Jason Hergenroeder Individual Corporate DirectorBoard Member Jan 1, 2015
Sarah Bogardus Individual Corporate OfficerBoard Member Apr 3, 2025
Vernon Palo Individual Corporate DirectorBoard Member Jan 1, 2019
James Pearson Individual Corporate OfficerBoard Member Apr 3, 2025
David Pontius Individual Corporate DirectorBoard Member Mar 1, 2019
Richard Trice Individual Corporate Director Jan 1, 2024
W-2 Managing Employee Jan 1, 2024
William Anderson Individual Corporate OfficerBoard Member Jul 1, 2025
Leonard Stepp Individual Corporate Officer Jan 1, 2022

Owners & managing parties with NPI records 5

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 35

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.

View all 35

Affiliated clinicians 5

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": "1135036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784505600000",
    "number": "1790761922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2863 STATE ROUTE 45 N",
            "address_2": "P.O. BOX 298",
            "city": "ROCK CREEK",
            "state": "OH",
            "postal_code": "440849352",
            "telephone_number": "440-563-3400",
            "fax_number": "440-563-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2863 STATE ROUTE 45 N",
            "address_2": "P O BO 298",
            "city": "ROCK CREEK",
            "state": "OH",
            "postal_code": "440849352",
            "telephone_number": "440-563-3400",
            "fax_number": "440-563-9363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20220 Center Ridge Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Rocky River",
            "state": "OH",
            "postal_code": "441163501",
            "country_code": "US",
            "telephone_number": "440-356-7620",
            "fax_number": "440-356-7623",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "29 North Rd",
            "address_purpose": "LOCATION",
            "city": "Niles",
            "state": "OH",
            "postal_code": "444461918",
            "country_code": "US",
            "telephone_number": "330-652-6770",
            "fax_number": "330-652-2069",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4661 Belpar St NW",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447183602",
            "country_code": "US",
            "telephone_number": "330-492-2600",
            "fax_number": "330-492-2603",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3526 Peach St",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165082742",
            "country_code": "US",
            "telephone_number": "814-864-4226",
            "fax_number": "814-864-4238",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3789 Green Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Beachwood",
            "state": "OH",
            "postal_code": "441225708",
            "country_code": "US",
            "telephone_number": "216-464-5800",
            "fax_number": "216-464-1840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GLENBEIGH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-20",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "DIRECTOR PFS",
        "authorized_official_telephone_number": "440-997-6622"
    },
    "taxonomies": [
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": "OH",
            "license": "6713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GLENBEIGH HEALTH SOURCES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rock Creek, OH

Sources for this page

Verify at the official NPI Registry.