NPIMap

Organization Active NPI

Mennonite Memorial Home

  • Skilled Nursing Facility
  • Bluffton, OH
National Provider Identifier
1831907005
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MENNONITE MEMORIAL HOME
Practice address
410 W Elm St
Bluffton, OH 45817-1122
Phone
(419) 358-1015
NPI assigned
Dec 20, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Authorized official

Name
John Warner
Title
Director
Phone
(937) 547-7605

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

410 W Elm St
Bluffton, OH 45817-1122

Mailing address

750 Chestnut St
Greenville, OH 45331-1312

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120521000433 OH Part A Provider - Skilled Nursing Facility 7214071976 1 other NPI on this enrollment
Practice locations: Bluffton, OH

Skilled nursing facility certification: CCN 366144

Legal name
MENNONITE MEMORIAL HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 15, 1997
Last certification
Nov 18, 2024
Beds
60
Ownership / control type
Church Related
Organization structure
CorporationNon-profit
Incorporated
Sep 5, 1947 in OH
Enrollment address
410 W Elm St
Bluffton, OH 45817-1122
Nursing home name
MENNONITE MEMORIAL HOME

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.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Mennonite Memorial HomeCCN 366144
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Church related
Certified
Aug 15, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6054.5 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Mennonite Memorial Home4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Lori Lynne Keller Individual Corporate DirectorBoard Member Dec 31, 2024
David Woodruff Individual Operational/Managerial Control Dec 31, 2024
Adp of the SNF Dec 31, 2024
David Kepler Individual Corporate DirectorBoard Member Dec 31, 2024
Lance Nickles Individual Operational/Managerial Control Apr 15, 2024
Adp of the SNF Apr 15, 2024
Steven Lester North Individual Corporate DirectorBoard Member Dec 31, 2024
Jeff Subler Individual Corporate DirectorBoard Member Dec 31, 2024
David Dean Shetler Individual Corporate DirectorBoard Member Dec 31, 2024
Brethren Retirement Community Organization, Greenville, OH Corporation, Non-profit 5% Or Greater Direct Ownership Interest Dec 31, 2024 100%
Adp of the SNF Dec 31, 2024
John Warner Individual Corporate OfficerPresident and Ceo Dec 31, 2024
Corporate DirectorBoard Member Dec 31, 2024
Kara L Allread Individual Corporate DirectorBoard Member Dec 31, 2024
Rebecca Susan Maurer Individual Corporate DirectorBoard Member Dec 31, 2024
Marjorie Lou Polhamus Individual Corporate DirectorBoard Member Dec 31, 2024
Matthew Arnold Individual Corporate DirectorBoard Member Dec 31, 2024

Owners & managing parties with NPI records 2

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 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1734652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734652800000",
    "number": "1831907005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 CHESTNUT ST",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "453311312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W ELM ST",
            "city": "BLUFFTON",
            "state": "OH",
            "postal_code": "458171122",
            "telephone_number": "419-358-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENNONITE MEMORIAL HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-20",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A",
        "authorized_official_last_name": "WARNER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "937-547-7605"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluffton, OH

Sources for this page

Verify at the official NPI Registry.