NPIMap

Organization Active NPI

Lower Lights Christian Health Center, Inc.

  • Primary Care Clinic/Center
  • Columbus, OH
National Provider Identifier
1033455209
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
LOWER LIGHTS CHRISTIAN HEALTH CENTER, INC.
Practice address
1160 W Broad St
Columbus, OH 43222-1317
Phone
(614) 274-1455
Fax
(614) 274-1433
NPI assigned
Dec 17, 2012
Last updated
Mar 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Authorized official

Name
Mrs. Tracy Cloud
Title
Ceo
Phone
(614) 274-1455

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

1160 W Broad St
Columbus, OH 43222-1317

Mailing address

1160 W Broad St
Columbus, OH 43222-1352
Phone (614) 274-1455

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140702000762 OH Part B Supplier - Clinic/Group Practice 5193794188 Receives reassigned benefits from 83 practitioners
11 other NPIs on this enrollment
Practice locations: Newark, OH; Westerville, OH; Marysville, OH; Columbus, OH

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory

Locations

1251 W Broad St
Columbus, OH 43222
Phone (614) 274-5572

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Lower Lights Christian Health Center IncColumbus, OH, CCN 361011 Federally qualified health center Operational/Managerial Control Nov 15, 2001

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 84

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 84

NPI Registry JSON

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

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646956800000",
    "number": "1033455209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221352",
            "telephone_number": "614-274-1455",
            "fax_number": "614-274-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221317",
            "telephone_number": "614-274-1455",
            "fax_number": "614-274-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWER LIGHTS CHRISTIAN HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-17",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A",
        "authorized_official_last_name": "CLOUD",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "614-274-1455",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.