MAD RIVER FAMILY PRACTICE
NPI 1003875949
Family Medicine in West Liberty, OH
About Mad River Family Practice NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MAD RIVER FAMILY PRACTICE (NPI 1003875949) is a healthcare organization registered as a family medicine in West Liberty, Ohio and active in the NPI registry since March 2006. The organization holds 2 active CLIA laboratory certificates and lists Ron Carmin, Vp/finance, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 2
Group Practice 1
CLIA Laboratory Certificates CMS CLIA 2
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Accreditation 36D0667939
Mary Rutan Hospital Patient Services · Bellefontaine, OHCertificate of Accreditation 36D0330718
Mary Rutan Hospital Clinical Lab · Bellefontaine, OHOther Providers at the Same Location NPPES 16
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mary Rutan Hospital's NPI number?
The NPI number for Mary Rutan Hospital is 1003875949. It was assigned to this organization in the NPPES registry on March 20, 2006. The provider is doing business as Mad River Family Practice.
Where is Mary Rutan Hospital located?
Mary Rutan Hospital is located at 4879 Us Highway 68 S, West Liberty, OH 43357. The listed phone number is (937) 599-1411.
What is Mary Rutan Hospital's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Does Mary Rutan Hospital hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
When was this NPI record last updated?
The NPPES record for Mary Rutan Hospital was last updated on July 10, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mad River Family Practice · NPI 1003875949
Family Medicine organization in West Liberty, Ohio. Organization record, active in the CMS NPPES registry since March 20, 2006.
## Identity
- **NPI:** 1003875949 (Entity type: Organization)
- **Enumerated:** March 20, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Mary Rutan Hospital
- **Organization subpart:** Yes (part of Mary Rutan Hospital)
- **Authorized official:** Ron Carmin, VP/FINANCE
## Practice location
- **Address:** 4879 US HIGHWAY 68 S, West Liberty, OH 43357-9525
- **Phone:** (937) 599-1411 · **Fax:** (937) 465-9945
## Record status
- **NPPES last updated:** July 10, 2007
- **Other identifiers:** Medicare ID-Type Unspecified MA9296981 (OH); Medicaid 2055332 (OH)
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1003875949) · Data from the CMS NPPES public registry.