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OTTERBEIN ST. MARYS
NPI 1154984565
Assisted Living Facility in St. Marys, OH

Active since April 22, 2019CLIA 36D0718118 · Waiver
11230 STATE ROUTE 364, ST. MARYS, OH 45885(419) 394-2366 Get Directions Write a Review

NPPES record last updated: April 22, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Otterbein St. Marys NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OTTERBEIN ST. MARYS (NPI 1154984565) is a healthcare organization registered as an assisted living facility in St. Marys, Ohio and active in the NPI registry since April 2019. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists James Chris Green, Treasurer & Cfo, as its authorized official.

NPPES Registry Identity

NPI1154984565
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameOTTERBEIN ST. MARYS
Location Address11230 STATE ROUTE 364St. Marys, OH 45885-9534
Mailing Address580 North State Route 741Lebanon, OH 45036-8839 · (513) 933-5401 · Fax (513) 932-1054
Phone(419) 394-2366
Organization SubpartYes
Authorized OfficialJames Chris GreenTreasurer & Cfo · (513) 933-5418
Enumeration DateApril 22, 2019
✔ NPI 1154984565 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
11230 STATE ROUTE 364, St. Marys, OH 45885
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Other Names 1

Other NameOtterbein St. Marys Assisted Living

CLIA Laboratory Certificates CMS CLIA

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 Waiver 36D0718118

Otterbein St Marys · St Marys, OH
Active · expires Aug 31, 2026
CLIA Number36D0718118
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorNeal Holleran
Laboratory Phone(419) 394-1622
Laboratory LocationOtterbein St Marys11230 Circle Dr State Route 364, St Marys, OH 45885
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. MELISSA KAY MICHAELS PTA
Physical Therapy Assistant
11230 STATE ROUTE 364
SAINT MARYS, OH 45885
Auglaize County (419) 326-8555
JENNA BOECKMAN PT, DPT
Physical Therapist
11230 STATE ROUTE 364
SAINT MARYS, OH 45885
Auglaize County (419) 394-6757
BRIANNE KNAPKE COTA/L
Occupational Therapy Assistant
11230 STATE ROUTE 364
SAINT MARYS, OH 45885
Auglaize County (419) 394-2366
CARLA MARIE SCHUTZ PTA
Physical Therapy Assistant
11230 STATE ROUTE 364
SAINT MARYS, OH 45885
Auglaize County (419) 394-6757
JERRICA HOLTHAUS
Speech-Language Pathologist
11230 STATE ROUTE 364
SAINT MARYS, OH 45885
Auglaize County (419) 394-6757
COURTNEY KLAUSING RRT
Respiratory Therapist, Registered
11230 STATE ROUTE 364
SAINT MARYS, OH 45885
Auglaize County (419) 394-6756
DIANE ALEXANDER
Physical Medicine & Rehabilitation
11230 STATE ROUTE 364
SAINT MARYS, OH 45885
Auglaize County (419) 394-2366
HEATHER MARIE WALE PTA
Physical Therapy Assistant
11230 STATE ROUTE 364
SAINT MARYS, OH 45885
Auglaize County (419) 394-2366

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 Otterbein St. Marys's NPI number?

The NPI number for Otterbein St. Marys is 1154984565. It was assigned to this organization in the NPPES registry on April 22, 2019. The provider is also known as Otterbein St. Marys Assisted Living.

Where is Otterbein St. Marys located?

Otterbein St. Marys is located at 11230 State Route 364, St. Marys, OH 45885. The listed phone number is (419) 394-2366.

What is Otterbein St. Marys's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Otterbein St. Marys hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D0718118) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Otterbein St. Marys was last updated on April 22, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.