NPIMap

Organization Active NPI

Three Lower Counties Community Services, Inc.

Doing business as Chesapeake Health Care

  • Federally Qualified Health Center (FQHC)
  • Berlin, MD
National Provider Identifier
1093485914
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
THREE LOWER COUNTIES COMMUNITY SERVICES, INC.
Doing business as
Chesapeake Health Care
Practice address
9958 N. Main Street
Berlin, MD 21811
Phone
(410) 973-2820
Fax
(410) 973-2843
NPI assigned
Sep 14, 2021
Last updated
Jul 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Authorized official

Name
Mr. Brian E Holland
Title
Ceo/President
Phone
(410) 749-1015

Specialties & licenses 1

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

Addresses

Primary practice location

9958 N. Main Street
Berlin, MD 21811

Mailing address

PO Box 1978
Salisbury, MD 21802-1978
Phone (410) 749-1015

Other identifiers 1

IdentifierTypeStateIssuer
119591316MedicaidMD

Other names 1

  • Chesapeake Health Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220406000414 MD Part A Provider - Federally Qualified Health Center (FQHC) 3678484300 Practice locations: Berlin, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093485914. Details of each certification follow.

Federally qualified health center certification: CCN 211937

Legal name
THREE LOWER COUNTIES COMMUNITY SERVICES INC
Doing business as
CHESAPEAKE HEALTH CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 28, 2022
Last certification
Feb 28, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 28, 1994 in MD
Enrollment address
9958 N Main St
Berlin, MD 21811-1076

Other NPIs with the same Medicare PAC ID 23

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

View all 23

National Provider Directory

National Provider Directory
Tax ID family
Abdul K Garuba37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

View all 36

Locations

9958 N Main St
Berlin, MD 21811
Phone (410) 973-2820

9958 N Main St
Bldg 5
Berlin, MD 21811

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Kathleen Crossan Individual Corporate DirectorBoard Member Mar 30, 2011
Paula D. Brown Individual Corporate DirectorBoard Member Mar 31, 2015
D'Arcy Nicole Green Individual Corporate DirectorVice Chairperson May 27, 2009
Three Lower Counties Community Services Inc Organization, Salisbury, MD Corporation, Non-profit Operational/Managerial Control Feb 28, 1994
Everett L. McCabe Individual Corporate DirectorTreasurer Sep 27, 2016
Lauren Taylor Individual Corporate DirectorSecretary Feb 27, 2008
Chris Labarge Individual Corporate DirectorChairperson Dec 16, 2009
Ernest D. Camarena Individual Corporate DirectorBoard Member Jan 28, 2014
Robert J. Laun Individual Corporate DirectorBoard Member Mar 25, 2014
Keisha Evans Individual Corporate DirectorBoard Member Feb 27, 2018
Cecilia Campbell Individual Corporate DirectorBoard Member Oct 29, 2019
Brian E Holland Individual Corporate Officer Jun 1, 2018
W-2 Managing Employee Jun 1, 2018
Operational/Managerial Control Jun 1, 2018
Other Jun 1, 2018

Owners & managing parties with NPI records 23

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

View all 23

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Chesapeake Health CarePrincess Anne, MD, CCN 211935 Federally qualified health center Operational/Managerial Control Jun 1, 2018
Chesapeake Health CareSalisbury, MD, CCN 211941 Federally qualified health center Operational/Managerial Control Feb 28, 1994
Chesapeake Health CarePocomoke City, MD, CCN 211943 Federally qualified health center Operational/Managerial Control Feb 28, 1994
Chesapeake Health CareSalisbury, MD, CCN 211010 Federally qualified health center Operational/Managerial Control Feb 28, 1994
Chesapeake Health CareBerlin, MD, CCN 211025 Federally qualified health center Operational/Managerial Control Feb 28, 1994

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 38

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 38

NPI Registry JSON

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753315200000",
    "number": "1093485914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1978",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218021978",
            "telephone_number": "410-749-1015",
            "fax_number": "410-749-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9958 N. MAIN STREET",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "21811",
            "telephone_number": "410-973-2820",
            "fax_number": "410-973-2843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE LOWER COUNTIES COMMUNITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-14",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "410-749-1015",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "119591316",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chesapeake Health Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Chesapeake Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berlin, MD

Sources for this page

Verify at the official NPI Registry.