NPIMap

Organization Active NPI

Ohio North East Health Systems, Inc

  • Federally Qualified Health Center (FQHC)
  • Warren, OH
National Provider Identifier
1033437702
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
OHIO NORTH EAST HEALTH SYSTEMS, INC
Practice address
1977 Niles Rd SE
Warren, OH 44484-5118
Phone
(330) 393-6446
NPI assigned
May 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Authorized official

Name
Dr. Ronald Dwinnells, M.D.
Title
Ceo
Phone
(330) 747-2330

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X
Federally Qualified Health Center (FQHC) 261QF0400X OH Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

1977 Niles Rd SE
Warren, OH 44484-5118

Mailing address

726 Wick Ave
Youngstown, OH 44505-2827
Phone (330) 747-9551

Other identifiers 1

IdentifierTypeStateIssuer
3059434MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110324000722 OH Part A Provider - Federally Qualified Health Center (FQHC) 1951395086 Practice locations: Warren, OH

Federally qualified health center certification: CCN 361970

Legal name
OHIO NORTH EAST HEALTH SYSTEMS INC
Doing business as
LLOYD MCCOY COMMUNITY HEALTH C ENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 25, 2011
Last certification
Mar 25, 2011
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 1, 1989 in OH
Enrollment address
1977 Niles Rd SE
Warren, OH 44484-5118

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Ohio North East Health Systems Inc23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
William Thornton Individual Corporate DirectorBoard Member Apr 27, 2021
Dan Rupp Individual Corporate DirectorBoard Member Jul 30, 2018
Dennis Kuhns Individual Corporate DirectorBoard Chairman Jul 30, 2018
Judy Eiland Individual Corporate DirectorBoard Member Oct 24, 2017
Susan Montalbano Individual W-2 Managing EmployeeCredentialing Coordinator Aug 4, 2014
Ronald Dwinnells Individual Corporate OfficerCeo May 21, 2010
Tanya Murphy Individual Corporate DirectorBoard Member Nov 29, 2016
Damon Dohar Individual Corporate DirectorBoard Member Jul 30, 2018
Victor Wan-Tatah Individual Corporate DirectorBoard Member May 21, 2010
Tammy Parteleno Individual Corporate DirectorBoard Member Jul 25, 2017
Patricia Rupp Individual Corporate DirectorBoard Member Jul 30, 2018
Rose Marie Pirone Individual Corporate DirectorBoard Member Dec 11, 2018

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1273017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1033437702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 WICK AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445052827",
            "telephone_number": "330-747-9551",
            "fax_number": "330-884-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1977 NILES RD SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444845118",
            "telephone_number": "330-393-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO NORTH EAST HEALTH SYSTEMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-05",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "DWINNELLS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "330-747-2330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "OH",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3059434",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.