Change, Incorporated
Organization Active NPI Federally Qualified Health Center (FQHC) · Weirton, WV
NPI 1245244367 · NPPES record last updated Oct 30, 2014
Key facts
- NPI
- 1245244367
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- CHANGE, INCORPORATED
- Practice address
- 3136 West St
Weirton, WV 26062-4635 - Phone
- (304) 797-7733
- NPI assigned
- Jul 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Judy Lynn Raveaux
- Title
- Chief Executive Officer
- Phone
- (304) 797-7733
Owners & managing parties with NPI records 1
-
Kelli L Fournier, MD
Practitioners 44
-
Tammy Lynn Aftanas, NP-C
-
Amanda Barnett, NP-C
-
Marcy Lynn Crago, MSW
-
Kelly Michele Devoogd, D.O.
-
Barbara Fahey, C.R.N.P.
-
Kelli L Fournier, MD
-
Larry R Gitelman, ADVANCED RN PRACT
-
Monica Michele Jones, FNP-BC
-
Lynn Marie Miller, NP-C
-
John P Schultz, M.D.
-
Kathleen Frances Sliva, FNP-C
-
Jessica Valesko, N.P
-
Rachel S Gilman, MD
-
Natalie Rae Holden, NP-C
-
Tina Marie Tiberio, FNP-BC
-
Daisy Bloomfield, MSW, LICSW
-
Kelly Shaw, DDS
-
Lori Tucker, DO
-
Eli Dragisich, OD
-
Kailey Littleton, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (19 enrollments) in WV, OH
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 · Non-profit
- 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 · Non-profit
- 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 · Non-profit
- 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 · Non-profit
- 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 · Non-profit
- 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 · Non-profit
- 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 · Non-profit
- 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 · Non-profit
- 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 · Non-profit
- 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 · Non-profit
- 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 · Non-profit
- 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 · Non-profit
- 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 · Non-profit
- 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 · Non-profit
- 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 · Non-profit
- 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 · Non-profit
- 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 · Non-profit
- Incorporated
- Mar 18, 1983 in WV
- Enrollment address
- 200 Rockdale Rd
Follansbee, WV 26037-1840
All disclosed owners & managing parties 15
| 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 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050614001275 | WV | Part B Supplier - Clinic/Group Practice | 1759325327 |
Receives reassigned benefits from 26 practitioners Practice locations: Newell, WV; Weirton, WV |
| O20061221000330 | WV | Part a Provider - Federally Qualified Health Center (FQHC) | 1759325327 | Practice locations: Weirton, WV |
| O20130111000013 | OH | Part a Provider - Federally Qualified Health Center (FQHC) | 1759325327 | Practice locations: Wintersville, OH |
| O20130304000156 | OH | Part B Supplier - Clinic/Group Practice | 1759325327 |
Receives reassigned benefits from 18 practitioners Practice locations: Mingo Junction, OH; Wintersville, OH |
| O20140630001386 | WV | Part a Provider - Federally Qualified Health Center (FQHC) | 1759325327 | Practice locations: Weirton, WV |
| O20160510000754 | WV | Part a Provider - Federally Qualified Health Center (FQHC) | 1759325327 | Practice locations: Newell, WV |
| O20180326002488 | WV | Part a Provider - Federally Qualified Health Center (FQHC) | 1759325327 | Practice locations: Wellsburg, WV |
| O20181016000087 | OH | Part a Provider - Federally Qualified Health Center (FQHC) | 1759325327 | Practice locations: Toronto, OH |
| O20190221001420 | WV | Part a Provider - Federally Qualified Health Center (FQHC) | 1759325327 | Practice locations: Weirton, WV |
| O20190221002991 | WV | Part a Provider - Federally Qualified Health Center (FQHC) | 1759325327 | Practice locations: New Cumberland, WV |
| O20200129003123 | OH | Part a Provider - Federally Qualified Health Center (FQHC) | 1759325327 | Practice locations: Steubenville, OH |
| O20200130001026 | OH | Part a Provider - Federally Qualified Health Center (FQHC) | 1759325327 | Practice locations: Steubenville, OH |
| O20200130001653 | OH | Part a Provider - Federally Qualified Health Center (FQHC) | 1759325327 | Practice locations: Steubenville, OH |
| O20200130002042 | OH | Part a Provider - Federally Qualified Health Center (FQHC) | 1759325327 | Practice locations: Steubenville, OH |
| O20200130002189 | OH | Part a Provider - Federally Qualified Health Center (FQHC) | 1759325327 | Practice locations: Steubenville, OH |
| O20211007000928 | WV | Part a Provider - Federally Qualified Health Center (FQHC) | 1759325327 | Practice locations: Wellsburg, WV |
| O20211021000470 | WV | Part a Provider - Federally Qualified Health Center (FQHC) | 1759325327 | Practice locations: Follansbee, WV |
| O20211026002338 | WV | Part a Provider - Federally Qualified Health Center (FQHC) | 1759325327 | Practice locations: Wellsburg, WV |
| O20211102003445 | WV | Part a Provider - Federally Qualified Health Center (FQHC) | 1759325327 | Practice locations: Follansbee, WV |
National Provider Directory
Locations
2379 Wilson Ave
Mingo Junction, OH 43938
Phone (304) 797-1210
200 Park Dr
Steubenville, OH 43953
320 N 4th St
Steubenville, OH 43952
Phone (740) 284-5712
936 N 5th St
Steubenville, OH 43952
Phone (740) 284-5712
420 N 4th St
Steubenville, OH 43952
Phone (740) 282-1651
2002 Sunset Blvd
Steubenville, OH 43952
Phone (740) 284-5712
435 John Scott Hwy
Steubenville, OH 43952
Phone (740) 264-1590
1305 Dennis Way
Toronto, OH 43964
Phone (740) 537-2172
200 Rockdale Rd
Follansbee, WV 26037
Phone (304) 527-0870
1098 Jefferson St
Follansbee, WV 26037
Phone (304) 527-2250
39 Golden Bear Dr
New Cumberland, WV 26047
Phone (304) 387-2363
3428 Pennsylvania Ave
Weirton, WV 26062
Phone (304) 748-8370
100 Red Rider Rd
Weirton, WV 26062
Phone (304) 748-2828
1305 Washington Pike
Wellsburg, WV 26070
Phone (304) 527-7461
1448 Main St
Wellsburg, WV 26070
Phone (304) 527-7461
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2161000 | Other | OH | CHANGE DBA FAMILY MEDICAL CARE CHC |
| 2733993 | Medicaid | OH | |
| 3810007536 | Medicaid | WV | |
| 361015 | Other | OH | 200 LURAY DRIVE WINTERSVILLE OH MEDICARE SITE # |
| 2160961 | Other | OH | CHANGE OH LICENSE |
Other names
- FAMILY MEDICAL CARE Community Health Center
Other providers in Weirton, WV
- Dana Chandler
- Change Inc
- Change Inc
- Change Inc Family Medical Care
- Change, Inc
- Change, Incorporated
- Kara Channels
- Amber Lynn Chappell
- Charles P Capito
- Amrik Singh Chattha
All providers in Weirton, WV · Federally Qualified Health Center (FQHC) in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 2014. 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.