NPIMap

Organization Active NPI

Lincoln Community Health Center Incorporated

  • Federally Qualified Health Center (FQHC)
  • Durham, NC
National Provider Identifier
1114978582
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LINCOLN COMMUNITY HEALTH CENTER INCORPORATED
Practice address
1301 Fayetteville St
Durham, NC 27707-2325
Phone
(919) 956-4000
NPI assigned
May 12, 2006
Last updated
Jul 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Authorized official

Name
Claretta Foye
Title
Chief Executive Officer
Phone
(919) 956-4022

Specialties & licenses 1

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

Addresses

Primary practice location

1301 Fayetteville St
Durham, NC 27707-2325

Mailing address

PO Box 52119
Durham, NC 27717-2119
Phone (919) 956-4000

Other identifiers 4

IdentifierTypeStateIssuer
03055OtherNCGROUP BC/BS ID NUMBER
344500CMedicaidNC
344500DMedicaidNC
344500AMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040707001353 NC Part B Supplier - Clinic/Group Practice 4587642590 Receives reassigned benefits from 81 practitioners
Practice locations: Durham, NC
O20041101000593 NC Part A Provider - Federally Qualified Health Center (FQHC) 4587642590 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Durham, NC
O20041102000124 NC Part A Provider - Federally Qualified Health Center (FQHC) 4587642590 Practice locations: Durham, NC

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1114978582. Details of each certification follow.

Federally qualified health center certification: CCN 341883

Legal name
LINCOLN COMMUNITY HEALTH CENTER INCORPORATED
Doing business as
JOHN H. LUCAS WELLNESS CENTER AT HILLSIDE HIGH SCHOOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 9, 2004
Last certification
Dec 9, 2004
Ownership / control type
Non-profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 25, 1972 in NC
Enrollment address
3727 Fayetteville St
Durham, NC 27707-4718

Federally qualified health center certification: CCN 341802

Legal name
LINCOLN COMMUNITY HEALTH CENTER INCORPORATED
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
Non-profit – other
Organization structure
CorporationNon-profit
Incorporated
May 25, 1972 in NC
Enrollment address
1301 Fayetteville St
Durham, NC 27707-2325

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

2020 Chapel Hill Rd
Ste 28
Durham, NC 27707
Phone (919) 956-4000

309 Crutchfield St
Durham, NC 27704
Phone (919) 560-7305

401 N Driver St
Durham, NC 27703
Phone (919) 530-8210

401 N Driver St
#1106
Durham, NC 27703

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Ana Velasquez Individual Corporate DirectorVolunteer Board Member Dec 20, 2020
Claudia Gabiota Zuniga Individual Corporate DirectorVolunteer Board Member Jul 1, 2022
Angel Vick-Lewis Individual Corporate DirectorVolunteer Board Member Mar 1, 2020
Kristin E Ito Individual Corporate OfficerCmo Apr 23, 2021
W-2 Managing EmployeeCmo Apr 23, 2021
Maggie Clapp Individual Corporate DirectorVolunteer Board Member Oct 1, 2024
Ronald Williams Individual Corporate DirectorVolunteer Board Member Feb 1, 2019
Elizabeth Stevens Individual Corporate DirectorVolunteer Board Member Nov 1, 2022
William Paul Seagroves Individual Corporate OfficerCfo Jun 16, 2014
W-2 Managing EmployeeCfo Jun 16, 2014
Ricky Leon Hart Individual Corporate DirectorVolunteer Board Member Mar 1, 2025
Claretta Foye Individual Corporate OfficerCoo Jan 1, 2010
W-2 Managing EmployeeCoo Jan 1, 2010
Corporate OfficerCeo Oct 1, 2021
W-2 Managing EmployeeCeo Oct 1, 2021
Valarie Jarvis Individual Corporate DirectorVolunteer Board Member Oct 1, 2024
Denise Lunsford Individual Corporate DirectorVolunteer Board Member Mar 1, 2025
Wendy Jacobs Individual Corporate DirectorVolunteer Board Member Mar 1, 2021
Dexter Nolley Individual Corporate DirectorVolunteer Board Member Nov 1, 2019
Jose Martinez Beltran Individual Corporate DirectorVolunteer Board Member Oct 1, 2023
Carlotta Jordan Individual Corporate DirectorVolunteer Board Member Jan 1, 2018
Corporate DirectorVolunteer Board Member Oct 1, 2018
Gregory Stephens Individual Corporate DirectorVolunteer Board Member Jul 1, 2024
Frank Whitehead Jr. Individual Corporate DirectorVolunteer Board Member Jul 1, 2024

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Lincoln Community Health Center IncorporatedDurham, NC, CCN 341885 Federally qualified health center Operational/Managerial Control May 25, 1972
Holton ClinicDurham, NC, CCN 341950 Federally qualified health center Operational/Managerial Control Jul 1, 2009

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 84

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 84

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658966400000",
    "number": "1114978582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52119",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277172119",
            "telephone_number": "919-956-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 FAYETTEVILLE ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072325",
            "telephone_number": "919-956-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN COMMUNITY HEALTH CENTER INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A",
        "authorized_official_last_name": "FOYE",
        "authorized_official_first_name": "CLARETTA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "919-956-4022"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP BC/BS ID NUMBER",
            "identifier": "03055",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344500C",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344500D",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344500A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.