NPIMap

Organization Active NPI

Hocking Valley Community Hospital

  • Rural Health Clinic/Center
  • Logan, OH
National Provider Identifier
1962059741
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HOCKING VALLEY COMMUNITY HOSPITAL
Practice address
1383 W Hunter St
Logan, OH 43138-1013
Phone
(740) 385-0202
Fax
(740) 380-2734
NPI assigned
Aug 26, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Authorized official

Name
Julie E Grow
Title
Cfo
Phone
(740) 380-8310

Specialties & licenses 1

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

Addresses

Primary practice location

1383 W Hunter St
Logan, OH 43138-1013

Mailing address

PO Box 966
Logan, OH 43138-0966
Phone (740) 380-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address HockingValleyCommunityHospital@direct-poc.osumc.edu Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190918001235 OH Part A Provider - Rural Health Clinic 7810896735 Practice locations: Logan, OH

Rural health clinic certification: CCN 363424

Legal name
HOCKING VALLEY COMMUNITY HOSPITAL
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 18, 2019
Last certification
Dec 18, 2019
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Incorporated
Jan 1, 1949 in OH
Enrollment address
1383 W Hunter St
Logan, OH 43138-1013
Related CCNs
361330

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

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Hocking Valley Community Hospital5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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
Randy Montgomery Individual 5% Or Greater Direct Ownership InterestCfo Mar 1, 2025
W-2 Managing EmployeeAd; Mar 1, 2025 100%
John Allen Ireton Individual W-2 Managing EmployeeMD; Jan 1, 2026
Kim Brown Individual Corporate OfficerPractice Support Aug 2, 2023
W-2 Managing EmployeePractice Support Aug 1, 2023

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 2

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

FacilityTypeRoleSince
Hocking Valley Community HospitalLogan, OH, CCN 361330 Hospital Operational/Managerial Control Jan 1, 1966
Hocking Valley Community HospitalLogan, OH, CCN 36Z330 Hospital Operational/Managerial Control
Other		 Jan 1, 1966
Jan 1, 1966

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1566777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607472000000",
    "number": "1962059741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 966",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "431380966",
            "telephone_number": "740-380-8000",
            "fax_number": "740-385-7458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1383 W HUNTER ST",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "431381013",
            "telephone_number": "740-385-0202",
            "fax_number": "740-380-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOCKING VALLEY COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-26",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A",
        "authorized_official_last_name": "GROW",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "740-380-8310"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "HockingValleyCommunityHospital@direct-poc.osumc.edu",
            "affiliation": "N",
            "endpointDescription": "HVCH Direct Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "1383 W Hunter St",
            "city": "Logan",
            "state": "OH",
            "country_code": "US",
            "postal_code": "431381013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Logan, OH

Sources for this page

Verify at the official NPI Registry.