NPIMap

Organization Active NPI

Adams County Regional Medical Center

  • Critical Access Hospital
  • Seaman, OH
National Provider Identifier
1851946909
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
ADAMS COUNTY REGIONAL MEDICAL CENTER
Practice address
230 Medical Center Dr
Seaman, OH 45679-8002
Phone
(937) 386-3400
Fax
(937) 386-3019
NPI assigned
Aug 6, 2019
Last updated
Jun 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Authorized official

Name
Pete R Dagenbach
Title
Cfo
Phone
(937) 386-3400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

230 Medical Center Dr
Seaman, OH 45679-8002

Mailing address

230 Medical Center Dr
Seaman, OH 45679-8002
Phone (937) 386-3400

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20191202001554 OH Part A Provider - Critical Access Hospital 8921431131 Receives reassigned benefits from 3 practitioners
Practice locations: Seaman, OH
O20200427002166 OH Part B Supplier - Clinic/Group Practice 8921431131 Receives reassigned benefits from 47 practitioners
5 other NPIs on this enrollment
Practice locations: Georgetown, OH; Seaman, OH; West Union, OH; Winchester, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851946909. Details of each certification follow.

Hospital certification: CCN 361326

Legal name
ADAMS COUNTY REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 1, 2004
Last certification
Mar 12, 2010
Beds
25
Ownership / control type
Local
Most recent change of ownership
Oct 1, 2019 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 2019 in OH
Enrollment address
230 Medical Center Dr
Seaman, OH 45679-8002
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 5

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Adams County Regional Medical CenterCCN 361326 · All quality measures
Overall star rating
3 of 5
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

4881 State Route 125
Georgetown, OH 45121
Phone (937) 378-2526

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Pete R Dagenbach Individual W-2 Managing EmployeeCfo Oct 1, 2019
Matthew a Armstrong Individual Corporate DirectorDirector Oct 1, 2019
Alan Bird Individual Corporate OfficerCeo Oct 1, 2019 100%
Corporate DirectorDirector Oct 1, 2019
Dane R Clark Individual Corporate Director Oct 1, 2019
Peggy Chalker Individual Corporate DirectorDirector Oct 1, 2019
Jack a McCoy Individual Corporate DirectorDirector Oct 1, 2019
Umb Bank National Association Organization, Minneapolis, MN Created for acquisition, Financial institution 5% Or Greater Mortgage Interest Oct 1, 2019 100%
5% Or Greater Security Interest Oct 1, 2019
Sherri M Spencer Individual Corporate DirectorDirector Oct 1, 2019
Chad Wilson Individual Corporate DirectorDirector Oct 1, 2019
Roy Gustin Individual Corporate DirectorDirector Oct 1, 2019

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Acrmc Family MedicineWinchester, OH, CCN 363431 Rural health clinic Operational/Managerial Control (100%) Oct 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 50

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 50

Affiliated clinicians 138

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 138

NPI Registry JSON

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623715200000",
    "number": "1851946909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 MEDICAL CENTER DR",
            "city": "SEAMAN",
            "state": "OH",
            "postal_code": "456798002",
            "telephone_number": "937-386-3400",
            "fax_number": "937-386-3019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 MEDICAL CENTER DR",
            "city": "SEAMAN",
            "state": "OH",
            "postal_code": "456798002",
            "telephone_number": "937-386-3400",
            "fax_number": "937-386-3019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADAMS COUNTY REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-06",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A",
        "authorized_official_last_name": "DAGENBACH",
        "authorized_official_first_name": "PETE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "937-386-3400"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seaman, OH

Sources for this page

Verify at the official NPI Registry.