NPIMap

Organization Active NPI

Healthfirst Family Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Laconia, NH
National Provider Identifier
1093080707
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HEALTHFIRST FAMILY CARE CENTER, INC.
Practice address
22 Strafford St
Laconia, NH 03246-4701
Phone
(603) 366-1070
Fax
(603) 366-1071
NPI assigned
Mar 13, 2012
Last updated
May 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Authorized official

Name
Russell Keene
Title
President/Ceo
Phone
(603) 934-0177

Specialties & licenses 1

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

Addresses

Primary practice location

22 Strafford St
Laconia, NH 03246-4701

Mailing address

841 Central St
Franklin, NH 03235-2026
Phone (603) 934-0177

Other identifiers 1

IdentifierTypeStateIssuer
30211899MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041117000908 NH Part B Supplier - Clinic/Group Practice 4183688211 Receives reassigned benefits from 31 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Laconia, NH; Franklin, NH
O20120320000169 NH Part A Provider - Federally Qualified Health Center (FQHC) 4183688211 1 other NPI on this enrollment
Practice locations: Laconia, NH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093080707. Details of each certification follow.

Federally qualified health center certification: CCN 301827

Legal name
HEALTHFIRST FAMILY CARE CENTER INC
Doing business as
HEALTHFIRST FAMILY CARE CENTER LACONIA
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 5, 2012
Last certification
Apr 5, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 23, 1996 in NH
Enrollment address
22 Strafford St
Laconia, NH 32464701

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 5

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
30D1060567Healthfirst Family Care Center22 Strafford St, Laconia, NH 03246Provider-performed microscopyApr 27, 2027

National Provider Directory

National Provider Directory

Locations

18 Roberts Rd
Canaan, NH 03741
Phone (603) 523-4343

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Stephanie Wolff Individual Corporate DirectorDirector Feb 1, 2023
Michael Stanley Individual Corporate DirectorBoard Member Jul 25, 2012
Dawn Sanchez Individual Corporate DirectorDirector Jul 1, 2020
Scott Burns Individual Corporate DirectorBoard Member Jun 1, 2015
Michael B Watto Individual Corporate DirectorMedical Director Jan 1, 2023
Peter Thurber Individual Corporate DirectorDirector Jan 1, 2024
Dennis Swett Individual Corporate DirectorDirector Jan 1, 2023
James Wells Individual Corporate DirectorBoard Member Jul 28, 2012
Michelle Lennon Individual Corporate DirectorBoard Member Jun 1, 2015
William Warren Individual Corporate DirectorDirector Jan 1, 2024
Lucy Grimard Individual Corporate OfficerDirector of Revenue Operations Jun 30, 2024
W-2 Managing EmployeeDirector of Revenue Operations Jun 30, 2024
Robert J. St. Jacques Individual Corporate DirectorBoard Member Jun 1, 2017
Matthew B Mackwood Individual Corporate DirectorDirector Jan 1, 2024
Ted Bolognani Individual Corporate OfficerCeo Jun 30, 2024
W-2 Managing EmployeeCeo Jun 30, 2024
Susan Lunt Individual Corporate DirectorBoard Member May 1, 2018
Melissa Frenette Individual Corporate DirectorDirector of Finance Jul 15, 2024
W-2 Managing EmployeeDirector of Finance Jul 15, 2024
Jennifer Ach Individual Corporate DirectorQuality Chair Jul 1, 2024
Susan Wnuk Individual Corporate DirectorBoard Member Mar 1, 2009
Myla H Harriett Everett Individual Corporate DirectorBoard Member Oct 1, 2019

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620259200000",
    "number": "1093080707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 CENTRAL ST",
            "city": "FRANKLIN",
            "state": "NH",
            "postal_code": "032352026",
            "telephone_number": "603-934-0177",
            "fax_number": "603-934-2805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 STRAFFORD ST",
            "city": "LACONIA",
            "state": "NH",
            "postal_code": "032464701",
            "telephone_number": "603-366-1070",
            "fax_number": "603-366-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHFIRST FAMILY CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-13",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A",
        "authorized_official_last_name": "KEENE",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "603-934-0177"
    },
    "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": "30211899",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laconia, NH

Sources for this page

Verify at the official NPI Registry.