NPIMap

Organization Active NPI

Southeast Inc

Doing business as Southeast Healthcare

  • Federally Qualified Health Center (FQHC)
  • Martins Ferry, OH
National Provider Identifier
1033866140
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SOUTHEAST INC
Doing business as
Southeast Healthcare
Practice address
301 Walnut St
Martins Ferry, OH 43935-1429
Phone
(614) 225-0980
Fax
(614) 225-0991
NPI assigned
Mar 8, 2022
Last updated
Jan 16, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHEAST INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

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

Authorized official

Name
Charles Tong
Title
Cfo
Phone
(614) 813-0177

Specialties & licenses 1

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

Addresses

Primary practice location

301 Walnut St
Martins Ferry, OH 43935-1429

Mailing address

PO Box 1809
Columbus, OH 43216-1809
Phone (614) 225-0990

Other identifiers 1

IdentifierTypeStateIssuer
0002518MedicaidOH

Other names 1

  • Southeast Healthcare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220622000646 OH Part A Provider - Federally Qualified Health Center (FQHC) 8426014853 Practice locations: Martins Ferry, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033866140. Details of each certification follow.

Federally qualified health center certification: CCN 721024

Legal name
SOUTHEAST INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 17, 2022
Last certification
Jun 17, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 9, 1978 in OH
Enrollment address
301 Walnut St
Martins Ferry, OH 43935-1429

Other NPIs with the same Medicare PAC ID 15

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

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Southeast Inc22 organizations share this tax ID, including this one
Part of
Southeast Inc

Other organizations with this tax ID 21

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

View all 21

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Kori J Manus Individual Corporate OfficerTreasurer May 1, 2013
Thomas Burns Individual Corporate OfficerPresident Feb 1, 2013
Eileen M Goodman Individual Corporate OfficerSecretary Jan 18, 2023
Corporate DirectorBoard Member Mar 1, 2000
Tom Shanahan Individual Corporate DirectorBoard Member Jan 18, 2023
Thomas Patrick Halaiko Individual Corporate DirectorBoard Member Jul 1, 2014
Art Deleon Individual Corporate DirectorBoard Member Jan 18, 2023
Angela Fry Individual Corporate OfficerVice President Jul 1, 2018
Sarah Lenkay Individual Corporate DirectorBoard Member Jan 18, 2023
Timothy Wheat Individual Corporate DirectorBoard Member Jan 18, 2023
Dave Lane Individual Corporate DirectorChairman Sep 1, 2021
Steve Sielschott Individual Corporate DirectorBoard Member Jan 1, 2019
William F Lee Individual Corporate OfficerChief Executive Officer Sep 1, 2007
W-2 Managing EmployeeChief Executive Officer Sep 1, 2007
Charles Chiahsing Tong Individual Corporate OfficerCfo May 5, 2025
Operational/Managerial ControlCfo May 5, 2025
Don Strasser Individual Corporate DirectorBoard Member Aug 1, 2018
Kate Hamilton Individual Corporate DirectorBoard Member Jul 1, 2014
Kim Krone Individual Corporate DirectorBoard Member Feb 1, 2016
Wendy Williams Individual Corporate OfficerCoo Dec 1, 2024

NPI Registry JSON

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

{
    "created_epoch": "1646697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768521600000",
    "number": "1033866140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1809",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432161809",
            "telephone_number": "614-225-0990",
            "fax_number": "614-225-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 WALNUT ST",
            "city": "MARTINS FERRY",
            "state": "OH",
            "postal_code": "439351429",
            "telephone_number": "614-225-0980",
            "fax_number": "614-225-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHEAST INC",
        "enumeration_date": "2022-03-08",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A",
        "authorized_official_last_name": "TONG",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "614-813-0177"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0002518",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Martins Ferry, OH

Sources for this page

Verify at the official NPI Registry.