NPIMap

Organization Active NPI

Lower Lights Christian Health Center, Inc.

  • Primary Care Clinic/Center
  • Columbus, OH
National Provider Identifier
1154630408
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
LOWER LIGHTS CHRISTIAN HEALTH CENTER, INC.
Practice address
777 W State St
Suite 201
Columbus, OH 43222-1536
Phone
(614) 274-1455
Fax
(614) 274-1433
NPI assigned
Oct 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Authorized official

Name
Michelle Armstrong
Title
Billing Director
Phone
(614) 274-1455

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X
Primary Care Clinic/Center 261QP2300X OH Primary

Addresses

Primary practice location

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

Mailing address

1160 W Broad St
Columbus, OH 43222-1352
Phone (614) 274-1455

Other identifiers 2

IdentifierTypeStateIssuer
3132407MedicaidOH
9319022OtherOHMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20111205000715 OH Part A Provider - Federally Qualified Health Center (FQHC) 5193794188 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbus, OH
O20140702000762 OH Part B Supplier - Clinic/Group Practice 5193794188 Receives reassigned benefits from 83 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Newark, OH; Westerville, OH; Marysville, OH; Columbus, OH

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 on the same Medicare enrollment 10

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

National Provider Directory

National Provider Directory

Locations

1160 W Broad St
Columbus, OH 43222
Phone (614) 947-7615

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

Practitioners & affiliated clinicians

Practitioners 77

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

View all 77

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646956800000",
    "number": "1154630408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221352",
            "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": "614-274-1455",
            "fax_number": "614-274-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWER LIGHTS CHRISTIAN HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-05",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A",
        "authorized_official_last_name": "ARMSTRONG",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "BILLING DIRECTOR",
        "authorized_official_telephone_number": "614-274-1455"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3132407",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "9319022",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.