NPIMap

Organization Active NPI

Sto-Rox Neighborhood Health Council, Inc.

  • Federally Qualified Health Center (FQHC)
  • MC Kees Rocks, PA
National Provider Identifier
1154354553
Registry record updated Aug 20, 2008
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
710 Thompson Ave
MC Kees Rocks, PA 15136-3808
Phone
(412) 771-6462
Fax
(412) 771-5887
NPI assigned
Jul 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2008

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

Authorized official

Name
Gail Lager
Title
Cfo
Phone
(412) 771-6462

Specialties & licenses 1

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

Addresses

Primary practice location

710 Thompson Ave
MC Kees Rocks, PA 15136-3808

Mailing address

710 Thompson Ave
MC Kees Rocks, PA 15136-3808
Phone (412) 771-6462

Other identifiers 1

IdentifierTypeStateIssuer
1007778110002MedicaidPA

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
Practice locations: MC Kees Rocks, PA; Pittsburgh, PA
O20101018001026 PA Part A Provider - Federally Qualified Health Center (FQHC) 6406840404 Practice locations: MC Kees Rocks, PA

Federally qualified health center certification: CCN 391816

Legal name
STO-ROX NEIGHBORHOOD HEALTH COUNCIL, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 1, 1991
Last certification
Dec 1, 1991
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Sep 23, 1971 in PA
Enrollment address
710 Thompson Ave
MC Kees Rocks, PA 15136-3808

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 DirectorChair Aug 1, 2020
Emelda Brown Individual Corporate OfficerBoard Member Nov 24, 2015
Aimee Mangham Individual Corporate DirectorDirector Aug 31, 2023
Terri Clemons Clark Individual W-2 Managing EmployeeDevelopment Director Aug 2, 2020
Brian Bayer Individual Corporate DirectorVice Chair Jul 1, 2020
Shelly Duncan Individual Corporate OfficerChief Executive Officer Jan 1, 2024
W-2 Managing EmployeeAd;Chief Executive Officer Jan 1, 2024
Vince Tarquinio Individual Corporate OfficerBoard Treasurer May 5, 1994
Marcy a Nordick Individual Corporate OfficerBoard Member Aug 10, 2010
Joan Delie Individual Corporate OfficerBoard Member Jan 23, 2018
Jonathan Backers Individual Corporate DirectorDirector Jun 30, 2023
Lorrie Meneely Individual Corporate OfficerChief Financial Officer May 4, 2020
W-2 Managing EmployeeAd;Chief Financial Officer May 4, 2020
Rain McCoy Individual Corporate DirectorDirector Aug 31, 2023
Fran Hogan Individual Corporate OfficerBoard President Mar 7, 1989
Stormie Parsons Individual Corporate DirectorDirector Jun 30, 2023

Practitioners & affiliated clinicians

Practitioners 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219190400000",
    "number": "1154354553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 THOMPSON AVE",
            "city": "MC KEES ROCKS",
            "state": "PA",
            "postal_code": "151363808",
            "telephone_number": "412-771-6462",
            "fax_number": "412-771-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 THOMPSON AVE",
            "city": "MC KEES ROCKS",
            "state": "PA",
            "postal_code": "151363808",
            "telephone_number": "412-771-6462",
            "fax_number": "412-771-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STO-ROX NEIGHBORHOOD HEALTH COUNCIL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2008-08-20",
        "status": "A",
        "authorized_official_last_name": "LAGER",
        "authorized_official_first_name": "GAIL",
        "authorized_official_title_or_position": "CFO",
        "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": "1007778110002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Kees Rocks, PA

Sources for this page

Verify at the official NPI Registry.