NPIMap

Organization Active NPI

Greater Lawrence Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Andover, MA
National Provider Identifier
1255630448
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
4943 Issued in MA
Legal business name
GREATER LAWRENCE FAMILY HEALTH CENTER, INC.
Practice address
57 River Rd
Andover, MA 01810-1144
Phone
(978) 686-8521
Fax
(978) 686-8594
NPI assigned
Mar 28, 2011
Last updated
Oct 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Authorized official

Name
Karin Bernard
Title
Director, Mso
Phone
(978) 689-6683

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 4943 MA Primary

Addresses

Primary practice location

57 River Rd
Andover, MA 01810-1144

Mailing address

57 River Rd
Andover, MA 01810-1144
Phone (978) 686-8521

Other identifiers 1

IdentifierTypeStateIssuer
1303775MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040805001067 MA Part B Supplier - Clinic/Group Practice 0446221956 Receives reassigned benefits from 134 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Methuen, MA; Lawrence, MA; Haverhill, MA; Andover, MA
O20110630000027 MA Part A Provider - Federally Qualified Health Center (FQHC) 0446221956 Practice locations: Andover, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255630448. Details of each certification follow.

Federally qualified health center certification: CCN 221899

Legal name
GREATER LAWRENCE FAMILY HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 17, 2011
Last certification
Jun 17, 2011
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 19, 1981 in MA
Enrollment address
57 River Rd
Andover, MA 18101144

Other NPIs with the same Medicare PAC ID 14

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 14

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory
Tax ID family
Greater Lawrence Fam HL10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Julieann Thurlow Individual Corporate DirectorBoard Member Sep 1, 2019
Abel Vargas Individual Corporate DirectorBoard Member Sep 1, 2018
Joanne Grega Individual Corporate DirectorBoard Member Oct 27, 2015
Rosa Pina Individual Corporate DirectorBoard Member Feb 29, 2016
Zandra S Kelley Individual Corporate OfficerCeo Sep 1, 2025
W-2 Managing EmployeeCeo Sep 1, 2025
Sharon Castillo Individual Corporate DirectorBoard Member Jun 4, 2024
Nicholas Rosenberg Individual Corporate DirectorBoard Member Oct 1, 2021
Daliza Nova Individual Corporate DirectorBoard Member Nov 12, 2024
Scott Hellen Individual Corporate DirectorBoard Member Feb 7, 2023
Ivanova Polanco Individual Corporate DirectorBoard Member Oct 1, 2021
Glendaly Pena Soto Individual Corporate DirectorBoard Member Jun 4, 2024
Andrea Vargas Individual Corporate DirectorBoard Member Nov 1, 2022
Nicholas Weida Individual Corporate OfficerSVP, Cmo Sep 14, 2025
Katelyn Reilly Individual Corporate DirectorBoard Member Jun 4, 2024
Charles Zanazzi Individual Corporate DirectorBoard Member Mar 10, 2011
Rafael E. Carmona Individual Corporate DirectorBoard Member Feb 7, 2023
Frances Sidley Individual Corporate DirectorBoard Member Sep 1, 2019

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1301270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759708800000",
    "number": "1255630448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 RIVER RD",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018101144",
            "telephone_number": "978-686-8521",
            "fax_number": "978-686-8594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 RIVER RD",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018101144",
            "telephone_number": "978-686-8521",
            "fax_number": "978-686-8594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER LAWRENCE FAMILY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-28",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A",
        "authorized_official_last_name": "BERNARD",
        "authorized_official_first_name": "KARIN",
        "authorized_official_title_or_position": "DIRECTOR, MSO",
        "authorized_official_telephone_number": "978-689-6683"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MA",
            "license": "4943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1303775",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MA

Sources for this page

Verify at the official NPI Registry.