NPIMap

Organization Active NPI

Lower Lights Christian Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Columbus, OH
National Provider Identifier
1144589193
Registry record updated May 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LOWER LIGHTS CHRISTIAN HEALTH CENTER INC
Practice address
777 W State St
Suite 201
Columbus, OH 43222-1536
Phone
(614) 234-5953
Fax
(614) 274-1433
NPI assigned
May 11, 2012
Last updated
May 11, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2012

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

Authorized official

Name
Dr. Dana Sue Vallangeon, MD
Title
Ceo
Phone
(614) 272-7639

Specialties & licenses 1

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

Addresses

Primary practice location

777 W State St
Suite 201
Columbus, OH 43222-1536

Mailing address

1251 W Broad St
Columbus, OH 43222-1359
Phone (614) 274-1455

Other identifiers 1

IdentifierTypeStateIssuer
361982OtherOHMEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111205000715 OH Part A Provider - Federally Qualified Health Center (FQHC) 5193794188 1 other NPI on this enrollment
Practice locations: Columbus, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1144589193. Details of each certification follow.

Federally qualified health center certification: CCN 361982

Legal name
LOWER LIGHTS CHRISTIAN HEALTH CENTER INC
Doing business as
NURSING CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 12, 2011
Last certification
Dec 12, 2011
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
Nov 15, 2001 in OH
Enrollment address
777 West State Street
Suite 201
Columbus, OH 43222-1359

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
Tax ID family
Lower Lights Christian HLTH13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Linda Hines Individual Corporate DirectorBoard Member Mar 1, 2018
Tracy Cloud Individual Corporate DirectorCeo Mar 1, 2018
Melodie Gee Individual Corporate OfficerCqo Mar 1, 2018
W-2 Managing EmployeeCqo Mar 1, 2018
Pauline Edwards Individual Corporate DirectorBoard Member Mar 1, 2018
Ellen Baugh Individual Corporate DirectorBoard Member Mar 1, 2018
Jennifer Diamond Individual Corporate DirectorBoard Member Mar 1, 2018

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Lower Lights Christian Health Center IncColumbus, OH, CCN 361011 Federally qualified health center Operational/Managerial Control Nov 15, 2001

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 5

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": "1336694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336694400000",
    "number": "1144589193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221359",
            "telephone_number": "614-274-1455",
            "fax_number": "614-274-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 W STATE ST",
            "address_2": "SUITE 201",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221536",
            "telephone_number": "614-234-5953",
            "fax_number": "614-274-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWER LIGHTS CHRISTIAN HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-11",
        "last_updated": "2012-05-11",
        "status": "A",
        "authorized_official_last_name": "VALLANGEON",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "614-272-7639",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "361982",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.