Active NPI
Change, Incorporated
Doing business as FAMILY MEDICAL CARE Community Health Center
- Federally Qualified Health Center (FQHC)
- Weirton, WV
National Provider Identifier
1245244367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- CHANGE, INCORPORATED
- Doing business as
- FAMILY MEDICAL CARE Community Health Center
- Practice address
- 3136 West St
Weirton, WV 26062-4635 - Phone
- (304) 797-7733
- NPI assigned
- Jul 27, 2006
- Last updated
- Oct 30, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Judy Lynn Raveaux
- Title
- Chief Executive Officer
- Phone
- (304) 797-7733
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Primary |
Addresses
Primary practice location
3136 West St
Weirton, WV 26062-4635
Mailing address
3136 West St
Weirton, WV 26062-4635
Phone (304) 797-7733
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2160961 | Other | OH | CHANGE OH LICENSE |
| 2733993 | Medicaid | OH | |
| 2161000 | Other | OH | CHANGE DBA FAMILY MEDICAL CARE CHC |
| 3810007536 | Medicaid | WV | |
| 361015 | Other | OH | 200 LURAY DRIVE WINTERSVILLE OH MEDICARE SITE # |
Other names 1
- FAMILY MEDICAL CARE Community Health Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV, OH
Enrollment records 19
NPI to CCN mapping 17
The Medicare certification numbers (CCNs) connected to NPI 1245244367. Details of each certification follow.
- CCN 511922
- CCN 361015
- CCN 511050
- CCN 511097
- CCN 511139
- CCN 361187
- CCN 511169
- CCN 511166
- CCN 721842
- CCN 721841
- CCN 721838
- CCN 721839
- CCN 721840
- CCN 581806
- CCN 581807
- CCN 581811
- CCN 581812
Federally qualified health center certification: CCN 511922
- Legal name
- CHANGE INCORPORATED
- Doing business as
- FAMILY MEDICAL CARE COMMUNITY HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Feb 23, 2007
- Last certification
- Feb 23, 2007
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Mar 18, 1983 in WV
- Enrollment address
- 3136 West Street
Weirton, WV 26062-4635
Federally qualified health center certification: CCN 361015
- Legal name
- CHANGE INCORPORATED
- Doing business as
- FAMILY MEDICAL CARE COMMUNITY HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jan 11, 2013
- Last certification
- Jan 11, 2013
- Ownership / control type
- For profit – partnership
- Organization structure
- Corporation
- Incorporated
- Mar 18, 1983 in WV
- Enrollment address
- 200 Luray Dr
Wintersville, OH 43953-3973
Federally qualified health center certification: CCN 511050
- Legal name
- CHANGE INCORPORATED
- Doing business as
- FMC SBHC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jun 5, 2014
- Last certification
- Jun 5, 2014
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Mar 18, 1983 in WV
- Enrollment address
- 3248 Pennsylvania Ave
Weirton, WV 26062-3804
Federally qualified health center certification: CCN 511097
- Legal name
- CHANGE INCORPORATED
- Doing business as
- FAMILY MEDICAL CARE
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Mar 25, 2016
- Last certification
- Mar 25, 2016
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Mar 19, 1983 in WV
- Enrollment address
- 1151 Washington St
Newell, WV 26050-1437
Federally qualified health center certification: CCN 511139
- Legal name
- CHANGE INCORPORATED
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Feb 14, 2018
- Last certification
- Feb 14, 2018
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Mar 18, 1983 in WV
- Enrollment address
- 29 Bruin Dr
Wellsburg, WV 26070-3064
Federally qualified health center certification: CCN 361187
- Legal name
- CHANGE INCORPORATED
- Doing business as
- FAMILY MEDICAL CARE COMMUNITY HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Oct 11, 2018
- Last certification
- Oct 11, 2018
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Mar 18, 1983 in WV
- Enrollment address
- 1305 Dennis Way
Toronto, OH 43964-1952
Federally qualified health center certification: CCN 511169
- Legal name
- CHANGE INCORPORATED
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jan 15, 2019
- Last certification
- Jan 15, 2019
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Mar 18, 1983 in WV
- Enrollment address
- 100 Red Rider Rd
Weirton, WV 26062-4270
Federally qualified health center certification: CCN 511166
- Legal name
- CHANGE INCORPORATED
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Feb 6, 2019
- Last certification
- Feb 6, 2019
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Mar 18, 1983 in WV
- Enrollment address
- 39 Golden Bear Dr
New Cumberland, WV 26047-1670
Federally qualified health center certification: CCN 721842
- Legal name
- CHANGE INCORPORATED
- Doing business as
- FMC COMMUNITY HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Dec 19, 2019
- Last certification
- Dec 19, 2019
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Mar 18, 1983 in WV
- Enrollment address
- 435 John Scott Hwy
Steubenville, OH 43952-3026
Federally qualified health center certification: CCN 721841
- Legal name
- CHANGE INCORPORATED
- Doing business as
- FMC COMMUNITY HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Dec 19, 2019
- Last certification
- Dec 19, 2019
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Mar 18, 1983 in WV
- Enrollment address
- 936 N 5TH St
Steubenville, OH 43952-1812
Federally qualified health center certification: CCN 721838
- Legal name
- CHANGE INCORPORATED
- Doing business as
- FMC COMMUNITY HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Dec 16, 2019
- Last certification
- Dec 16, 2019
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Mar 18, 1983 in WV
- Enrollment address
- 2002 Sunset Blvd
Steubenville, OH 43952-1381
Federally qualified health center certification: CCN 721839
- Legal name
- CHANGE INCORPORATED
- Doing business as
- FMC COMMUNITY HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Dec 16, 2019
- Last certification
- Dec 16, 2019
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Mar 18, 1983 in WV
- Enrollment address
- 420 N 4TH St
Steubenville, OH 43952-2022
Federally qualified health center certification: CCN 721840
- Legal name
- CHANGE INCORPORATED
- Doing business as
- FMC COMMUNITY HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Dec 16, 2019
- Last certification
- Dec 16, 2019
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Mar 18, 1983 in WV
- Enrollment address
- 1400 Adams St
Steubenville, OH 43952-2678
Federally qualified health center certification: CCN 581806
- Legal name
- CHANGE INCORPORATED
- Doing business as
- FMC COMMUNITY HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Sep 3, 2021
- Last certification
- Sep 3, 2021
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Mar 18, 1983 in WV
- Enrollment address
- 1448 Main St
Wellsburg, WV 26070-1420
Federally qualified health center certification: CCN 581807
- Legal name
- CHANGE INCORPORATED
- Doing business as
- FMC COMMUNITY HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Sep 3, 2021
- Last certification
- Sep 3, 2021
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Mar 18, 1983 in WV
- Enrollment address
- 1098 Jefferson St
Follansbee, WV 26037-1311
Federally qualified health center certification: CCN 581811
- Legal name
- CHANGE INCORPORATED
- Doing business as
- FMC COMMUNITY HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Sep 13, 2021
- Last certification
- Sep 13, 2021
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Mar 18, 1983 in WV
- Enrollment address
- 1305 Washington Pike
Wellsburg, WV 26070-2225
Federally qualified health center certification: CCN 581812
- Legal name
- CHANGE INCORPORATED
- Doing business as
- FMC COMMUNITY HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Sep 13, 2021
- Last certification
- Sep 13, 2021
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Mar 18, 1983 in WV
- Enrollment address
- 200 Rockdale Rd
Follansbee, WV 26037-1840
National Provider Directory
National Provider DirectoryLocations
2379 Wilson Ave
Mingo Junction, OH 43938
Phone (304) 797-1210
2002 Sunset Blvd
Steubenville, OH 43952
Phone (740) 284-5712
320 N 4th St
Steubenville, OH 43952
Phone (740) 284-5712
420 N 4th St
Steubenville, OH 43952
Phone (740) 282-1651
435 John Scott Hwy
Steubenville, OH 43952
Phone (740) 264-1590
936 N 5th St
Steubenville, OH 43952
Phone (740) 284-5712
1305 Dennis Way
Toronto, OH 43964
Phone (740) 537-2172
200 Park Dr
Wintersville, OH 43953
1098 Jefferson St
Follansbee, WV 26037
Phone (304) 527-2250
200 Rockdale Rd
Follansbee, WV 26037
Phone (304) 527-0870
39 Golden Bear Dr
New Cumberland, WV 26047
Phone (304) 387-2363
100 Red Rider Rd
Weirton, WV 26062
Phone (304) 748-2828
3032 West St
Weirton, WV 26062
Phone (304) 748-2828
3428 Pennsylvania Ave
Weirton, WV 26062
Phone (304) 748-8370
1305 Washington Pike
Wellsburg, WV 26070
Phone (304) 527-7461
1448 Main St
Wellsburg, WV 26070
Phone (304) 527-7461
29 Bruin Dr
Wellsburg, WV 26070
Phone (304) 527-1410
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Joann Mulrooney | Corporate Director | Jun 1, 2014 | |
| Geraldine Thorne | Corporate Director | Oct 28, 2019 | |
| Kelli L Fournier | W-2 Managing Employee | Apr 25, 2005 | |
| James Boniey | W-2 Managing Employee | Jul 16, 1990 | |
| Lisa Werner | Corporate Director | Mar 1, 2011 | |
| James Brown | Corporate Director | Feb 1, 2020 | |
| Lisa Mowry | Corporate Director | Jan 1, 2022 | |
| W-2 Managing Employee | Jan 1, 2022 | 100% | |
| Corporate Director | Jan 1, 2022 | 100% | |
| Operational/Managerial Control | Jan 1, 2022 | 100% | |
| Corporate Officer | Jan 1, 2022 | ||
| Corporate Officer | Jan 1, 2022 | 100% | |
| Corporate Director | Jan 1, 2022 | 100% | |
| W-2 Managing Employee | Jan 1, 2022 | 100% | |
| Operational/Managerial Control | Jan 1, 2022 | 100% | |
| W-2 Managing Employee | Jan 1, 2022 | ||
| Tamara Pettit | Corporate Director | Nov 22, 2004 | |
| Corporate Director | Nov 1, 2004 | ||
| John Pizzuti | Corporate Director | Nov 1, 2005 | |
| Larry Dorsch | Corporate Director | Aug 1, 2012 | |
| Karen Simpson | Corporate Director | Nov 1, 2015 | |
| Corporate Director | Nov 1, 2015 | ||
| Judy Raveaux | W-2 Managing Employee | Mar 18, 1983 | |
| Corporate Officer | Mar 18, 1983 | ||
| W-2 Managing Employee | Feb 1, 1983 | ||
| Operational/Managerial Control | Mar 18, 1983 | ||
| Alecia Ford | Corporate Director | Nov 1, 2015 | |
| Lora Bailey | Corporate Director | Jun 1, 2014 | |
| Corporate Director | Jun 1, 2014 | ||
| Mark Phillips | Corporate Director | Jan 1, 2021 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
Practitioners & affiliated clinicians
Practitioners 45
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.
-
- Psychiatry Physician
- Weirton, WV
- NPI 1902875743
-
- Family Nurse Practitioner
- Newell, WV
- NPI 1942725684
-
- Social Worker
- Weirton, WV
- NPI 1902052079
-
- Obstetrics Physician
- Weirton, WV
- NPI 1780810192
-
- Family Nurse Practitioner
- Weirton, WV
- NPI 1689671703
-
- Family Medicine Physician
- Weirton, WV
- NPI 1588652499
-
- Psychiatric/Mental Health Nurse Practitioner
- Weirton, WV
- NPI 1568438539
-
- Family Nurse Practitioner
- Weirton, WV
- NPI 1235680372
-
- Addiction Medicine (Family Medicine) Physician
- Weirton, WV
- NPI 1730176900
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1414627200000",
"number": "1245244367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3136 WEST ST",
"city": "WEIRTON",
"state": "WV",
"postal_code": "260624635",
"telephone_number": "304-797-7733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3136 WEST ST",
"city": "WEIRTON",
"state": "WV",
"postal_code": "260624635",
"telephone_number": "304-797-7733"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHANGE, INCORPORATED",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-27",
"last_updated": "2014-10-30",
"status": "A",
"authorized_official_last_name": "RAVEAUX",
"authorized_official_first_name": "JUDY",
"authorized_official_middle_name": "LYNN",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "304-797-7733"
},
"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": "CHANGE OH LICENSE",
"identifier": "2160961",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2733993",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHANGE DBA FAMILY MEDICAL CARE CHC",
"identifier": "2161000",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810007536",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "200 LURAY DRIVE WINTERSVILLE OH MEDICARE SITE #",
"identifier": "361015",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "FAMILY MEDICAL CARE Community Health Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Weirton, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.