Knox County General Health District
Organization Active NPI Federally Qualified Health Center (FQHC) · Mount Vernon, OH
NPI 1265207658 · NPPES record last updated Nov 16, 2023
Key facts
- NPI
- 1265207658
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- KNOX COUNTY GENERAL HEALTH DISTRICT
- Practice address
- 202 W Vine St
Mount Vernon, OH 43050-2458 - Phone
- (740) 399-8008
- Fax
- (740) 392-9613
- NPI assigned
- Nov 16, 2023
- Organization subpart
- No
Authorized official
- Name
- Mr. Lane Keyes Belangia
- Title
- Ceo
- Phone
- (740) 392-2200
Owners & managing parties with NPI records 7
Owned or controlled facilities with NPI records 6
Other NPIs with the same Medicare PAC ID 7
Corporate family (same tax ID) 9
Facilities with the same owner 6
Practitioners 18
-
Paige Cunningham, APRN-CNP
-
Jill Hunter, CNP
-
Jennie M. McClain, RN,DNP, FNP-BC
-
Karla Renee Adu, CNP
-
Morgan Willis, APRN-CNP
-
Sarah E Davis, LSW
-
William A Elder, MD
-
Stacy Gilley, LISW
-
Ciara Haas, PMHNP-BC
-
Simona Lydia Moore, C.N.P.
-
Nancy V Rodway, MD
-
Lauren Sanders, LISW, MSW
-
Bailey Sapp, LSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Federally qualified health center certification: CCN D21026
- Legal name
- KNOX COUNTY GENERAL HEALTH DISTRICT
- Doing business as
- MOUNT VERNON HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Dec 18, 2023
- Last certification
- Dec 18, 2023
- Ownership / control type
- For profit – corporation
- Organization structure
- Government · Non-profit
- Enrollment address
- 202 W Vine St
Mount Vernon, OH 43050-2458
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Jason Whaley |
Corporate Officer |
Jul 1, 2022 | |
| Zachary Green |
Corporate Officer |
Jan 1, 2024 | |
| W-2 Managing Employee |
Jan 1, 2024 | ||
| Jeff Harmer |
Corporate Officer |
Jul 1, 2022 | |
| Knox County General Health District |
5% Or Greater Direct Ownership Interest | Jan 1, 2024 | 100% |
| Operational/Managerial Control | Jan 1, 2024 | 100% |
All facility ownership & control disclosures 6
| Facility | Type | Role | Since |
|---|---|---|---|
| Knox County Community Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2017 |
| Danville Community Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Nov 18, 2019 |
| Knox County Dental |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jan 11, 2021 |
| Kcchc Walk-in Clinic |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) 5% Or Greater Security Interest (100%) |
Jan 1, 2022 Jan 1, 2022 |
| Behavioral Health of Mount Vernon Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) 5% Or Greater Security Interest (100%) |
Jan 1, 2022 Jan 1, 2022 |
| Centerburg Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Sep 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231218002441 | OH | Part a Provider - Federally Qualified Health Center (FQHC) | 8820078595 | Practice locations: Mount Vernon, OH |
National Provider Directory
- Tax ID family
- Knox County Board of MRDD
Locations
207 W High St
Ste A
Mount Vernon, OH 43050
202 W Vine St
Mount Vernon, OH 43050
Phone (740) 399-8008
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
202 W Vine St
Mount Vernon, OH 43050-2458
Mailing address
11660 Upper Gilchrist Rd
Mount Vernon, OH 43050-9084
Phone (740) 392-2200
Other names
- Mount Vernon Health Center
Other providers in Mount Vernon, OH
- Knox Community Hospital
- Knox Community Hospital
- Knox County Board of MRDD
- Knox County Esc
- Knox County General Health District
- Knox County General Health District
- Knox County General Health District
- Knox County General Health District
- Knox County General Health District
- Knox County Vision Center LLC
All providers in Mount Vernon, OH · Federally Qualified Health Center (FQHC) in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2023. 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.