Family Health Services of Erie County
Organization Active NPI Federally Qualified Health Center (FQHC) · Castalia, OH
NPI 1144947482 · NPPES record last updated Apr 30, 2024
Key facts
- NPI
- 1144947482
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- FAMILY HEALTH SERVICES OF ERIE COUNTY
- Practice address
- 207 Lowell St RM 212
Castalia, OH 44824-9332 - Phone
- (419) 502-2800
- Fax
- (419) 502-2821
- NPI assigned
- Oct 27, 2022
- Organization subpart
- No
Authorized official
- Name
- David Tatro
- Title
- Chief Executive Officer
- Phone
- (419) 502-2822
Other NPIs with the same Medicare PAC ID 20
Corporate family (same tax ID) 20
Practitioners 25
-
Amber Renee Barton, FNP-C
-
Matthew A Braniecki, D.O.
-
Paul J Bruner, D.O.
-
Valerie J Castillo, CNP
-
Melissa Hollada, LPCC
-
Tracey A Hylton, APRN.CNP
-
Jennifer Lynn Kearney, NP-C
-
Aaron Martinez, DO
-
Eric Mast, DO
-
Leslie L Neuberger, RN, CNP
-
Mary A Peters, MSN, APRN, PMHNP-BC
-
Nicole Lauren Sanoba, PA-C
-
Cheri Lynn Slingwine, PMHNP-BC
-
Laura Elizabeth Spasic, NP-C
-
Joseph Veliz, LISW-S
-
Josalyn Marie Woodruff, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Federally qualified health center certification: CCN 361817
- Legal name
- FAMILY HEALTH SERVICES OF ERIE COUNTY
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jan 19, 2023
- Last certification
- Jan 19, 2023
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jul 21, 2008 in OH
- Enrollment address
- 207 Lowell St
RM 212
Castalia, OH 44824-9332
All disclosed owners & managing parties 19
| Name | Role | Since | Share |
|---|---|---|---|
| Brent William Burkey |
Corporate Director | Dec 1, 2019 | |
| David Tatro |
Corporate Officer |
Jul 8, 2019 | 100% |
| W-2 Managing Employee |
Jul 8, 2019 | 100% | |
| Paul Keech |
Corporate Director |
May 1, 2017 | |
| James Preston |
Corporate Officer |
Jan 1, 2018 | |
| Corporate Director |
Jan 1, 2018 | ||
| Kathy Pace |
Corporate Director |
Dec 1, 2018 | |
| Mattie Sparks |
Corporate Officer |
Nov 11, 2019 | 100% |
| Corporate Director |
Jan 1, 2018 | 100% | |
| Donald Branum |
Corporate Director |
May 1, 2017 | |
| Jack C. Runner |
Corporate Officer |
Jan 1, 2020 | 100% |
| Corporate Director |
Jan 1, 2020 | 100% | |
| Daniel Moncher |
Corporate Director |
May 1, 2017 | |
| Jessica Khaledi |
Corporate Director |
Dec 1, 2019 | |
| Edward Widman |
Corporate Director |
Oct 1, 2017 | |
| Marietta Johnson |
Corporate Officer |
Oct 1, 2008 | |
| Corporate Director |
Oct 1, 2008 | ||
| Pamela Brumbaugh |
Corporate Director |
May 1, 2017 | |
| Kaye Burel |
Corporate Director |
Dec 1, 2018 | |
| Nancy McKeen |
Corporate Officer |
Oct 1, 2008 | |
| Corporate Director |
Oct 1, 2008 | ||
| William Zucker |
Corporate Director |
Oct 1, 2008 | |
| Charles Poole |
Corporate Director |
Feb 1, 2017 | |
| Marlana Binkley |
Corporate Director |
Oct 1, 2017 | |
| Anthony Pool |
Corporate Director |
Oct 1, 2008 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230321001006 | OH | Part a Provider - Federally Qualified Health Center (FQHC) | 0749345296 | Practice locations: Castalia, OH |
National Provider Directory
- Tax ID family
- Family Health Services of Erie County
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes | ||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X |
Addresses
Primary practice location
207 Lowell St RM 212
Castalia, OH 44824-9332
Mailing address
1912 Hayes Ave Ste D
Sandusky, OH 44870-4736
Phone (419) 502-2800
Other providers in Castalia, OH
- Katelyn Deborde
- Kyle G. Denihan
- Kendra S Didion
- Theresa Didion
- Erie County Office of Auditor
- Family Health Services of Erie County
- Family Health Services of Erie County
- Joyce Farmer
- Catherine Fellenstein
- John Ferguson III
All providers in Castalia, OH · Federally Qualified Health Center (FQHC) in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.