NPIMap

Organization Active NPI

Country Drive Inn Medical Practice

  • Rural Health Clinic/Center
  • Mount Perry, OH
National Provider Identifier
1821840067
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
COUNTRY DRIVE INN MEDICAL PRACTICE
Doing business as
Country Drive Inn Medical Practice
Practice address
10825 Township Road 49
Mount Perry, OH 43760-9779
Phone
(740) 221-6550
NPI assigned
Apr 2, 2024
Last updated
Sep 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Authorized official

Name
Arica Lynnette Reeves, APRNNPI 1891081998
Title
Owner
Phone
(740) 683-5165

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

10825 Township Road 49
Mount Perry, OH 43760-9779

Mailing address

10825 Township Road 49
Mount Perry, OH 43760-9779
Phone (740) 221-6550

Other names 1

  • Country Drive Inn Medical Practice Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230428002017 OH Part B Supplier - Clinic/Group Practice 8224493168 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mount Perry, OH
O20241029003936 OH Part A Provider - Rural Health Clinic 8224493168 Practice locations: Mount Perry, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821840067. Details of each certification follow.

Rural health clinic certification: CCN 363881

Legal name
COUNTRY DRIVE INN MEDICAL PRACTICE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 9, 2025
Last certification
Jan 9, 2025
Ownership / control type
1A
Organization structure
LLCProprietary
Incorporated
May 11, 2022 in OH
Enrollment address
10825 Township Road 49
Mount Perry, OH 43760-9779

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Country Drive Inn Medical Practice2 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 3

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

NameRoleSinceShare
Arica L Reeves Individual 5% Or Greater Direct Ownership InterestOwner/Aprn May 11, 2022 100%
Operational/Managerial ControlOperations Manager May 11, 2022 100%
Jeffrey P Vanmeter Individual Contracted Managing EmployeeMD; Oct 1, 2025
Country Drive Inn Medical Practice Organization, Mount Perry, OH LLC Operational/Managerial Control May 11, 2022 100%

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1712016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756944000000",
    "number": "1821840067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10825 TOWNSHIP ROAD 49",
            "city": "MOUNT PERRY",
            "state": "OH",
            "postal_code": "437609779",
            "telephone_number": "740-221-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10825 TOWNSHIP ROAD 49",
            "city": "MOUNT PERRY",
            "state": "OH",
            "postal_code": "437609779",
            "telephone_number": "740-221-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY DRIVE INN MEDICAL PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-02",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A",
        "authorized_official_last_name": "REEVES",
        "authorized_official_first_name": "ARICA",
        "authorized_official_middle_name": "LYNNETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "740-683-5165",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Country Drive Inn Medical Practice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Country Drive Inn Medical Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Perry, OH

Sources for this page

Verify at the official NPI Registry.