NPIMap

Organization Active NPI

Care Alliance

Doing business as Care Alliance Health Center

  • Federally Qualified Health Center (FQHC)
  • Cleveland, OH
National Provider Identifier
1023406469
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
847979 Issued in OH
Legal business name
CARE ALLIANCE
Doing business as
Care Alliance Health Center
Practice address
1530 Saint Clair Ave NE
Cleveland, OH 44114-2004
Phone
(216) 535-9100
Fax
(216) 298-5015
NPI assigned
Jan 8, 2015
Last updated
Feb 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Authorized official

Name
Mr. Claude L Jones, DONPI 1952570863
Title
President &Ceo
Phone
(216) 535-9100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 847979 OH Primary

Addresses

Primary practice location

1530 Saint Clair Ave NE
Cleveland, OH 44114-2004

Mailing address

1530 Saint Clair Ave NE
Cleveland, OH 44114-2004
Phone (216) 781-6228

Other practice location 1

2916 Central Ave
Cleveland, OH 44115
Phone (216) 781-6228 ext. 225

Other names 1

  • Care Alliance Health Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140521001309 OH Part B Supplier - Clinic/Group Practice 8527034818 Receives reassigned benefits from 33 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cleveland, OH
O20150420000374 OH Part A Provider - Federally Qualified Health Center (FQHC) 8527034818 Practice locations: Cleveland, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023406469. Details of each certification follow.

Federally qualified health center certification: CCN 361071

Legal name
CARE ALLIANCE
Doing business as
CARE ALLIANCE HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 20, 2015
Last certification
Mar 20, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 21, 1993 in OH
Enrollment address
2916 Central Ave
Cleveland, OH 44115-3229

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory

Locations

1736 Superior Ave
Cleveland, OH 44114
Phone (440) 406-7736

2227 Payne Ave
Cleveland, OH 44114
Phone (216) 479-0200

3470 E 152nd St
Cleveland, OH 44120
Phone (216) 767-4060

5005 Euclid Ave
Cleveland, OH 44103

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Shannon Fogarty-Jerse Individual Corporate DirectorVice Chairman Jan 1, 2020
Jennifer Demmerle Individual Corporate DirectorTreasurer Jan 1, 2021
Claude L Jones Individual Corporate OfficerPresident & Ceo Jan 22, 2020
Operational/Managerial ControlPresident &Ceo Jan 22, 2020
Anthony Felici Individual W-2 Managing EmployeeVice President of Finance Jul 10, 2017
Operational/Managerial ControlDirector of Finance Jul 10, 2017
Renee Richard Individual Corporate DirectorChairman Jan 1, 2022
Lolita M McDavid Individual Corporate DirectorSecretary Jan 1, 2022

Owners & managing parties with NPI records 2

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
Care Alliance Health CenterCleveland, OH, CCN 361894 Federally qualified health center Operational/Managerial Control Jan 22, 2020

Owned or controlled facilities with NPI records 1

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

  • Care Alliance
    • Federally Qualified Health Center (FQHC)
    • Cleveland, OH
    • NPI 1083881114

    Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 36

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 36

NPI Registry JSON

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

{
    "created_epoch": "1420675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612310400000",
    "number": "1023406469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 SAINT CLAIR AVE NE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441142004",
            "telephone_number": "216-781-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 SAINT CLAIR AVE NE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441142004",
            "telephone_number": "216-535-9100",
            "fax_number": "216-298-5015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2916 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "44115",
            "country_code": "US",
            "telephone_number": "216-781-6228 x225",
            "fax_number": "216-298-5015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CARE ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-08",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CLAUDE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT &CEO",
        "authorized_official_telephone_number": "216-535-9100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "OH",
            "license": "847979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Care Alliance Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Care Alliance Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.