NPIMap

Organization Active NPI

Five Rivers Health Centers

  • Federally Qualified Health Center (FQHC)
  • Dayton, OH
National Provider Identifier
1114280690
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FIVE RIVERS HEALTH CENTERS
Practice address
2261 Philadelphia Dr
Suite 100
Dayton, OH 45406
Phone
(937) 734-6841
NPI assigned
Jun 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Ms. Gina McFarlane-El
Title
Ceo
Phone
(937) 281-6800

Specialties & licenses 1

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

Addresses

Primary practice location

2261 Philadelphia Dr
Suite 100
Dayton, OH 45406

Mailing address

721 Miami Chapel Rd
Dayton, OH 45417-4650
Phone (937) 281-6800

Other names 1

  • Family Health Center Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121031000193 OH Part A Provider - Federally Qualified Health Center (FQHC) 9335300904 Practice locations: Dayton, OH

Federally qualified health center certification: CCN 361007

Legal name
FIVE RIVERS HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 31, 2012
Last certification
Oct 31, 2012
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Feb 25, 2011 in OH
Enrollment address
2261 Philadelphia Dr
Dayton, OH 45406-1814

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Five Rivers Health Centers19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Locations

2261 Philadelphia Dr
Ste 100
Dayton, OH 45406
Phone (937) 734-6841

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Mamle Anim Individual Corporate OfficerChief Medical Officer May 23, 2011
Brenda Jean Roman Individual Corporate DirectorBoard Member Apr 13, 2016
Diane Welborn Individual Corporate DirectorBoard Member Apr 1, 2012
Resta Zeremariam Individual Corporate DirectorBoard Member Oct 13, 2022
Dwight Brown Individual Corporate DirectorBoard Member Apr 1, 2012
Jo Bouchard Individual Corporate DirectorBoard Member May 11, 2017
Richard Goshay Individual Corporate DirectorBoard Member Apr 1, 2012
Tara Roesch Individual W-2 Managing EmployeeChief Financial Officer Nov 1, 2018
Gina M McFarlane-El Individual Corporate OfficerChief Executive Officer May 23, 2011 100%
Operational/Managerial ControlCeo May 23, 2011 100%
Dawn Walker Individual Corporate DirectorBoard Member Jun 12, 2018
Jennifer Wentzel Individual Corporate DirectorBoard Member Oct 13, 2022
Amy Wiedeman Individual Corporate DirectorBoard President Apr 1, 2012
Five Rivers Health Centers Organization, Dayton, OH Non-profit Operational/Managerial Control May 23, 2011 100%

Owners & managing parties with NPI records 9

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

Practitioners & affiliated clinicians

Practitioners 45

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1114280690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 MIAMI CHAPEL RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454174650",
            "telephone_number": "937-281-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2261 PHILADELPHIA DR",
            "address_2": "SUITE 100",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45406",
            "telephone_number": "937-734-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE RIVERS HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-20",
        "last_updated": "2025-09-02",
        "certification_date": "2025-06-19",
        "status": "A",
        "authorized_official_last_name": "MCFARLANE-EL",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "937-281-6800",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.