NPIMap

Organization Active NPI

Sto-Rox Neighborhood Health Council, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pittsburgh, PA
National Provider Identifier
1114339371
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
STO-ROX NEIGHBORHOOD HEALTH COUNCIL, INC.
Practice address
151 Ruth Street
Pittsburgh, PA 15211-2308
Phone
(412) 431-3520
NPI assigned
May 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

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

Authorized official

Name
Regis J Ryan
Title
Executive Director
Phone
(412) 771-6462

Specialties & licenses 1

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

Addresses

Primary practice location

151 Ruth Street
Pittsburgh, PA 15211-2308

Mailing address

151 Ruth Street
Pittsburgh, PA 15211-2308
Phone (412) 431-3520

Other identifiers 2

IdentifierTypeStateIssuer
100777811 0008MedicaidPA
100777811 0007MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040413000399 PA Part B Supplier - Clinic/Group Practice 6406840404 Receives reassigned benefits from 25 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: MC Kees Rocks, PA; Pittsburgh, PA
O20101019001530 PA Part A Provider - Federally Qualified Health Center (FQHC) 6406840404 1 other NPI on this enrollment
Practice locations: Pittsburgh, PA

Federally qualified health center certification: CCN 391938

Legal name
STO-ROX NEIGHBORHOOD HEALTH COUNCIL, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 5, 2004
Last certification
May 5, 2004
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 23, 1971 in PA
Enrollment address
151 Ruth St
Pittsburgh, PA 15211-2384
Related CCNs
391816

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

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 2

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 15

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

NameRoleSinceShare
Adrienne Roberts Individual Corporate DirectorDirector Aug 31, 2020
Peter Ennis Individual Corporate DirectorPresident Apr 1, 2020
Emelda Brown Individual Corporate DirectorBoard Member Nov 24, 2015
Aimee Mangham Individual Corporate DirectorDirector Aug 31, 2023
Terri Clemons Clark Individual W-2 Managing EmployeeDevelopment Director Aug 2, 2020
Operational/Managerial ControlExecutive Director Apr 1, 2020
Brian Bayer Individual Corporate DirectorBoard Member Jul 1, 2020
Shelly Duncan Individual W-2 Managing EmployeeInterim Ceo Jan 1, 2024
Vince Tarquinio Individual Corporate OfficerTreasurer Apr 1, 2020
Marcy a Nordick Individual Corporate DirectorBoard Member Aug 10, 2010
Joan Delie Individual Corporate DirectorBoard Member Jan 23, 2018
Jonathan Backers Individual Corporate DirectorDirector Jun 30, 2023
Lorrie Meneely Individual Corporate OfficerChief Financial Officer May 4, 2020
Operational/Managerial ControlChief Financial Officer Apr 1, 2020
Rain McCoy Individual Corporate DirectorDirector Aug 31, 2023
Fran Hogan Individual Corporate DirectorSecretary Apr 1, 2020
Stormie Parsons Individual Corporate DirectorDirector Jun 30, 2023

Practitioners & affiliated clinicians

Practitioners 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405468800000",
    "number": "1114339371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 RUTH STREET",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152112308",
            "telephone_number": "412-431-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 RUTH STREET",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152112308",
            "telephone_number": "412-431-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STO-ROX NEIGHBORHOOD HEALTH COUNCIL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-22",
        "last_updated": "2014-07-16",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "REGIS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "412-771-6462"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100777811 0008",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100777811 0007",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.