NPIMap

Organization Active NPI

Care Alliance

  • Federally Qualified Health Center (FQHC)
  • Cleveland, OH
National Provider Identifier
1083881114
Registry record updated Mar 9, 2023
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
Practice address
6001 Woodland Ave
Cleveland, OH 44104-2762
Phone
(216) 923-5000
Fax
(216) 923-5004
NPI assigned
May 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Authorized official

Name
Claude Jones, DO
Title
Chief Executive Officer
Phone
(216) 535-9100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 847979 OH
Federally Qualified Health Center (FQHC) 261QF0400X 847979 OH Primary

Addresses

Primary practice location

6001 Woodland Ave
Cleveland, OH 44104-2762

Mailing address

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

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050617000529 OH Part A Provider - Federally Qualified Health Center (FQHC) 8527034818 Practice locations: Cleveland, OH
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

Federally qualified health center certification: CCN 361894

Legal name
CARE ALLIANCE
Doing business as
CARE ALLIANCE HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 22, 2005
Last certification
Jul 22, 2005
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jun 21, 1993 in OH
Enrollment address
6001 Woodland Avenue
Cleveland, OH 44104-2762
Related CCNs
361863

Facilities connected through Provider of Services related, parent or unit certification numbers.

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

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 DirectorBoard Or Directors Jan 1, 2021
Jennifer Demmerle Individual Corporate DirectorBoard of Directors Jan 1, 2020
Claude L Jones Individual Corporate OfficerPresident & Ceo Jan 22, 2020
W-2 Managing EmployeePresident and Ceo Jan 22, 2020
Anna Kacki Individual W-2 Managing EmployeeController Jun 28, 2022
Operational/Managerial ControlController Jun 28, 2020
Michael a Finch Individual W-2 Managing EmployeeChief Financial Officer Jun 28, 2022
Operational/Managerial ControlChief Financial Officer Jun 28, 2020
Care Alliance Organization, Cleveland, OH Non-profit Operational/Managerial Control Jan 22, 2020

Owners & managing parties with NPI records 4

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

Practitioners & affiliated clinicians

Practitioners 9

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": "1210204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678320000000",
    "number": "1083881114",
    "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",
            "fax_number": "216-298-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 WOODLAND AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441042762",
            "telephone_number": "216-923-5000",
            "fax_number": "216-923-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-08",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CLAUDE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "216-535-9100",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OH",
            "license": "847979",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "OH",
            "license": "847979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.