NPIMap

H.B. Magruder Memorial Hospital

Organization Active NPI Critical Access Hospital · Port Clinton, OH

NPI 1922079532 · NPPES record last updated Dec 11, 2024

Key facts

NPI
1922079532
Entity type
Organization (NPI type 2)
Primary specialty
Critical Access Hospital 282NC0060X
License
1252 (OH)
Legal business name
H.B. MAGRUDER MEMORIAL HOSPITAL
Practice address
615 Fulton St
Port Clinton, OH 43452-2001
Phone
(419) 734-3131
NPI assigned
Jan 31, 2006
Organization subpart
No

Authorized official

Name
Nick Marsico
Title
President/Ceo
Phone
(419) 734-3131

Owners & managing parties with NPI records 1

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

Other NPIs on the same Medicare enrollment 1

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

Other NPIs with the same Medicare PAC ID 1

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

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

Practitioners 29

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

View all 29

Affiliated clinicians 210

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

View all 210

Medicare Care Compare: Hospital

Listed as
Magruder Hospital CCN 361314
Overall star rating
★★★☆☆ 3 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in OH

Hospital certification: CCN 361314

Legal name
H.B. MAGRUDER MEMORIAL HOSPITAL
Doing business as
MAGRUDER HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Dec 1, 2002
Last certification
Dec 18, 2003
Beds
15
Ownership / control type
Private (not for profit)
Organization structure
Corporation · Non-profit
Incorporated
Jan 29, 1940 in OH
Enrollment address
615 Fulton St
Port Clinton, OH 43452-2001
Other Hospital Practice Location

All disclosed owners & managing parties 24

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

NameRoleSinceShare
Nancy Osborn
Individual 		Corporate Director Dec 5, 2003
Alison Falls
Individual 		Corporate Director Jul 30, 2019
Jill R Crawford
Individual 		W-2 Managing Employee Jan 4, 2016
Operational/Managerial Control
Director		 Jan 4, 2016
Paul Druckenmiller
Individual 		Corporate Director Apr 24, 2007
Michael Libben
Individual 		Corporate Director Jul 30, 2019
Kevin Sneider
Individual 		Corporate Director Apr 29, 2008
Greg Deerhake
Individual 		Corporate Director May 26, 2009
Jason Kraus
Individual 		W-2 Managing Employee Oct 7, 2012
Operational/Managerial Control
Director		 Oct 7, 2012
Robert Goshia
Individual 		W-2 Managing Employee
Ad;VP Finance & Cfo		 Aug 2, 2023
Maria Crosser
Individual 		Corporate Director May 26, 2009
Ronald Miller
Individual 		Corporate Director May 25, 1999
Nicholas Marisco
Individual 		Corporate Director Jan 12, 2006
W-2 Managing Employee Jan 12, 2006
Operational/Managerial Control
President and Ceo		 Jan 12, 2006
Delbert a Hatt
Individual 		W-2 Managing Employee Dec 21, 2020
Operational/Managerial Control Dec 21, 2020
Douglas Focht
Individual 		Corporate Director Apr 29, 1997
Mark Sprenger
Individual 		Corporate Director May 31, 2022
Deborah Hall
Individual 		W-2 Managing Employee Apr 16, 2007
Operational/Managerial Control
Director		 Apr 16, 2007
Barry Cover
Individual 		Corporate Director Apr 24, 2018
Edmund Neumann
Individual 		W-2 Managing Employee May 20, 2024
Kimberly D Schreiner
Individual 		Corporate Director Aug 19, 2019
W-2 Managing Employee
VP Nursing and Cno		 Aug 19, 2019
Mark Hablitzel
Individual 		Corporate Director Apr 24, 2007
Toni Magsig
Individual 		W-2 Managing Employee Dec 8, 1983
Operational/Managerial Control
Director		 Dec 8, 1983
David Soderberg
Individual 		Corporate Director Apr 25, 1995
Jeff Dornbusch
Individual 		Corporate Director Sep 27, 2016
Christopher Singerling
Individual 		Corporate Director May 31, 2022

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031205000057 OH Part B Supplier - Clinic/Group Practice 8921915786 Receives reassigned benefits from 23 practitioners
1 other NPI on this enrollment
Practice locations: Port Clinton, OH
O20061104000080 OH Part a Provider - Critical Access Hospital 8921915786 Receives reassigned benefits from 6 practitioners
Practice locations: Port Clinton, OH; Oak Harbor, OH

National Provider Directory

Locations

615 Fulton St
Ste F
Port Clinton, OH 43452

611 Fulton St
Ste C
Port Clinton, OH 43452
Phone (419) 732-6500

611 Fulton St
Ste F
Port Clinton, OH 43452
Phone (419) 732-6776

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X
Critical Access Hospital 282NC0060X 1252 OH Yes

Addresses

Primary practice location

615 Fulton St
Port Clinton, OH 43452-2001

Mailing address

615 Fulton St
Port Clinton, OH 43452-2001
Phone (419) 734-3131

Other identifiers

IdentifierTypeStateIssuer
361314OtherOHHUMANA MEDICARE HMO
600827OtherOHBUCKEYE COMMUNITY
0062084OtherOHAETNA
05029OtherOHPARAMOUNT INSURANCE
395857OtherOHBLACK LUNG
000000064558OtherOHUNICARE
107536OtherOHKAISER
5430662MedicaidOH
000000064558OtherOHANTHEM
344442792OtherOHTRICARE

Other names

  • Magruder Hospital Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 11, 2024.

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1922079532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 FULTON ST",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434522001",
            "telephone_number": "419-734-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 FULTON ST",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434522001",
            "telephone_number": "419-734-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H.B. MAGRUDER MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A",
        "authorized_official_last_name": "MARSICO",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "419-734-3131"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "OH",
            "license": "1252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA MEDICARE HMO",
            "identifier": "361314",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE COMMUNITY",
            "identifier": "600827",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0062084",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT INSURANCE",
            "identifier": "05029",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "395857",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE",
            "identifier": "000000064558",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "107536",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5430662",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000064558",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "344442792",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magruder Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Magruder Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Clinton, OH

All providers in Port Clinton, OH · Critical Access Hospital in Ohio

Sources for this page

Verify at the official NPI Registry.