NPIMap

Organization Active NPI

Equitas Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Toledo, OH
National Provider Identifier
1063239911
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
EQUITAS HEALTH, INC
Practice address
613 W Alexis Rd
Toledo, OH 43612
Phone
(833) 378-4827
NPI assigned
Sep 23, 2024
Last updated
Apr 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Authorized official

Name
Karen Shepherd
Title
Director of Revenue
Phone
(833) 378-4827

Specialties & licenses 1

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

Addresses

Primary practice location

613 W Alexis Rd
Toledo, OH 43612

Mailing address

1105 Schrock Rd Ste 400
Columbus, OH 43229-1174
Phone (833) 378-4827

Other identifiers 1

IdentifierTypeStateIssuer
0168816MedicaidOH

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120830000276 OH Part B Supplier - Clinic/Group Practice 2769638154 Receives reassigned benefits from 59 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbus, OH; Toledo, OH; Portsmouth, OH; Dayton, OH; Cincinnati, OH; Athens, OH; Akron, OH
O20241113004238 OH Part A Provider - Federally Qualified Health Center (FQHC) 2769638154 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Toledo, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063239911. Details of each certification follow.

Federally qualified health center certification: CCN D21059

Legal name
EQUITAS HEALTH,INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 13, 2024
Last certification
Nov 13, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 24, 2016 in OH
Enrollment address
3450 W Central Ave
Ste 104
Toledo, OH 43606-1403

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
AIDS Resource Center Ohio Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

15 W 4th St
Ste 200
Dayton, OH 45402
Phone (937) 853-3650

195 Union St
Ste B1
Newark, OH 43055
Phone (740) 281-5210

3450 W Central Ave
Ste 104
Toledo, OH 43606
Phone (833) 378-4827

613 W Alexis Rd
Toledo, OH 43612
Phone (614) 987-5621

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
David E Munar Individual Corporate OfficerCeo Apr 1, 2024
Jeffery Bernard McNeal Individual Corporate OfficerCfo Feb 28, 2024
Equitas Health,Inc Organization, Columbus, OH Non-profit Operational/Managerial Control Apr 1, 2024
Karen Jean Shepherd Individual Operational/Managerial Control Sep 23, 2024
Susan Willis Individual Operational/Managerial Control Sep 23, 2024

Owners & managing parties with NPI records 6

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

Practitioners & affiliated clinicians

Practitioners 95

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 95

NPI Registry JSON

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

{
    "created_epoch": "1727049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775692800000",
    "number": "1063239911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SCHROCK RD STE 400",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432291174",
            "telephone_number": "833-378-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 W ALEXIS RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43612",
            "telephone_number": "833-378-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUITAS HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-23",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "DIRECTOR  OF REVENUE",
        "authorized_official_telephone_number": "833-378-4827"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0168816",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.