NPIMap

Organization Active NPI

Henry County Hospital Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Napoleon, OH
National Provider Identifier
1811915929
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
270733 Issued in OH
Legal business name
HENRY COUNTY HOSPITAL INC
Practice address
1600 E Riverview Ave
Napoleon, OH 43545-9805
Phone
(419) 592-4015
Fax
(419) 591-3855
NPI assigned
Jul 17, 2006
Last updated
Aug 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Authorized official

Name
Kimberly H Bordenkircher
Title
Ceo
Phone
(419) 592-4015

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 270733 OH Primary

Addresses

Primary practice location

1600 E Riverview Ave
Napoleon, OH 43545-9805

Mailing address

1600 E Riverview Ave
Napoleon, OH 43545-9805
Phone (419) 592-4015

Other identifiers 1

IdentifierTypeStateIssuer
3822751MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address prod@henrycountyhospital.medicity.net

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081027000569 OH Part A Provider - Critical Access Hospital 0345141644 Practice locations: Napoleon, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811915929. Details of each certification follow.

Hospital certification: CCN 36Z309

Legal name
HENRY COUNTY HOSPITAL INC
Organization structure
CorporationNon-profit
Incorporated
Apr 19, 1958 in OH
Enrollment address
1600E Riverview Ave
Napoleon, OH 43545-9805
Hospital Swing-Bed Unit

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
Liberty Center Family P2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Joy-Ann Ermie Individual Corporate DirectorBoard Member Jan 1, 2021
James Burkhart Individual Corporate DirectorBoard Member Mar 1, 2014
Brent Gerken Individual Corporate DirectorBoard Member Jan 1, 2017
Melissa Peper Firestone Individual Corporate DirectorBoard Member Jan 1, 2023
Marvin Barlow Individual Corporate DirectorPresident of Board Sep 1, 2008
Kristi Barnd Individual Corporate OfficerCeo Aug 4, 2020
Corporate DirectorCeo Aug 4, 2020
W-2 Managing Employee Aug 4, 2020
OtherCeo Aug 4, 2020
Michael D Carpenter Individual Corporate DirectorBoard Member Jan 1, 2018
Rick Fruth Individual Corporate DirectorBoard Member Sep 1, 2008

Owners & managing parties with NPI records 1

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

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": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1811915929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E RIVERVIEW AVE",
            "city": "NAPOLEON",
            "state": "OH",
            "postal_code": "435459805",
            "telephone_number": "419-592-4015",
            "fax_number": "419-591-3855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E RIVERVIEW AVE",
            "city": "NAPOLEON",
            "state": "OH",
            "postal_code": "435459805",
            "telephone_number": "419-592-4015",
            "fax_number": "419-591-3855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY COUNTY HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "BORDENKIRCHER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "419-592-4015"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "OH",
            "license": "270733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3822751",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "prod@henrycountyhospital.medicity.net",
            "affiliation": "N",
            "address_1": "1600 E Riverview Ave",
            "city": "Napoleon",
            "state": "OH",
            "country_code": "US",
            "postal_code": "435459805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Napoleon, OH

Sources for this page

Verify at the official NPI Registry.