NPIMap

Organization Active NPI

First Choice Community Health Centers

  • General Practice Physician
  • Lillington, NC
National Provider Identifier
1083971279
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
FIRST CHOICE COMMUNITY HEALTH CENTERS
Practice address
40 Autumn Fern Trail
Lillington, NC 27546-9998
Phone
(910) 893-5402
Fax
(910) 893-2567
NPI assigned
Apr 12, 2012
Last updated
Sep 8, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
FIRST CHOICE COMMUNITY HEALTH CENTERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Authorized official

Name
Ms. Sheila L Simmons
Title
Chief Executive Officer
Phone
(910) 364-0971

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

40 Autumn Fern Trail
Lillington, NC 27546-9998

Mailing address

40 Autumn Fern TRL
Lillington, NC 27546-5155
Phone (910) 364-0971

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040908001617 NC Part B Supplier - Clinic/Group Practice 0941276133 Receives reassigned benefits from 10 practitioners
4 other NPIs on this enrollment
Practice locations: Lillington, NC
O20121004000395 NC Part A Provider - Federally Qualified Health Center (FQHC) 0941276133 Practice locations: Lillington, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083971279. Details of each certification follow.

Federally qualified health center certification: CCN 341988

Legal name
FIRST CHOICE COMMUNITY HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 10, 2012
Last certification
Oct 10, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 11, 1978 in NC
Enrollment address
40 Autumn Fern Trail
Lillington, NC 27546-9998

Other NPIs with the same Medicare PAC ID 1

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
Part of
First Choice Community Health Centers

Locations

6750 Overhills Rd
Spring Lake, NC 28390
Phone (910) 436-2600

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Ronald D Davis Individual Corporate DirectorBoard Member Jan 1, 2007 10%
Raymond E Cole Individual Corporate DirectorBoard Member Mar 1, 2011 10%
Rachel M Barnes Individual Corporate DirectorBoard Member Sep 1, 1998 10%
Sheila L Simmons Individual Corporate OfficerCeo Aug 1, 2002 100%
W-2 Managing EmployeeCeo Aug 27, 2012 100%
Robin a Jones Individual Corporate DirectorBoard Member Jun 1, 2004 10%
Eugene C Gonzales Individual Corporate DirectorBoard Member Jan 1, 2011 10%
Edward I Fubara Individual Corporate DirectorBoard Member Feb 1, 2006 10%
Kathryn L Ferguson Individual Corporate DirectorBoard Member Jan 1, 2011 10%
Catherine B Evans Individual Corporate DirectorBoard Member Apr 1, 2006 10%

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 34

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 34

NPI Registry JSON

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757289600000",
    "number": "1083971279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 AUTUMN FERN TRL",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "275465155",
            "telephone_number": "910-364-0971",
            "fax_number": "910-814-4064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 AUTUMN FERN TRAIL",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "275469998",
            "telephone_number": "910-893-5402",
            "fax_number": "910-893-2567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CHOICE COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIRST CHOICE COMMUNITY HEALTH CENTERS",
        "enumeration_date": "2012-04-12",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "910-364-0971",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lillington, NC

Sources for this page

Verify at the official NPI Registry.