NPIMap

Organization Active NPI

Equitas Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Dayton, OH
National Provider Identifier
1255846515
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
EQUITAS HEALTH, INC
Practice address
1222 S Patterson Blvd Ste 230
Dayton, OH 45402-2643
Phone
(833) 378-4827
Fax
(833) 222-8164
NPI assigned
Dec 8, 2017
Last updated
Mar 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Authorized official

Name
Karen Shepherd
Title
Director of Revenue Cycle
Phone
(833) 378-4827

Specialties & licenses 1

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

Addresses

Primary practice location

1222 S Patterson Blvd Ste 230
Dayton, OH 45402-2643

Mailing address

1105 Schrock Rd Ste 400
Columbus, OH 43229-1174
Phone (833) 378-4827

Other identifiers 1

IdentifierTypeStateIssuer
279161MedicaidOH

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120830000276 OH Part B Supplier - Clinic/Group Practice 2769638154 Receives reassigned benefits from 59 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbus, OH; Toledo, OH; Portsmouth, OH; Dayton, OH; Cincinnati, OH; Athens, OH; Akron, OH
O20180329001314 OH Part A Provider - Federally Qualified Health Center (FQHC) 2769638154 Practice locations: Dayton, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255846515. Details of each certification follow.

Federally qualified health center certification: CCN 361157

Legal name
EQUITAS HEALTH,INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 8, 2018
Last certification
Mar 8, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 26, 1984 in OH
Enrollment address
1222 S Patterson Blvd
Ste 230
Dayton, OH 45402-2643

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 7

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2046253Equitas Health Centers1222 S Patterson Blvd Suite 230, Dayton, OH 45402Provider-performed microscopyMay 19, 2028

National Provider Directory

National Provider Directory

Locations

8 W Stimson Ave
Athens, OH 45701
Phone (740) 331-4165

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Jeffery Bernard McNeal Individual Corporate OfficerCfo Apr 1, 2024
Susan Willis Individual W-2 Managing EmployeePayer Credentialing Manager Jul 13, 2023

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Equitas Health,IncToledo, OH, CCN D21059 Federally qualified health center Operational/Managerial Control Apr 1, 2024

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1512691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774915200000",
    "number": "1255846515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SCHROCK RD STE 400",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432291174",
            "telephone_number": "833-378-4827",
            "fax_number": "833-222-8164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 S PATTERSON BLVD STE 230",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454022643",
            "telephone_number": "833-378-4827",
            "fax_number": "833-222-8164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUITAS HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-08",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "833-378-4827"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279161",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.