NPIMap

Organization Active NPI

Heart of Ohio Family Health Centers

Doing business as Capital Park Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Columbus, OH
National Provider Identifier
1275714289
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HEART OF OHIO FAMILY HEALTH CENTERS
Doing business as
Capital Park Family Health Center
Practice address
2365 Innis Rd
Columbus, OH 43224-3730
Phone
(614) 416-4325
Fax
(614) 416-4320
NPI assigned
Nov 19, 2007
Last updated
Oct 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Authorized official

Name
Lashonda Bond
Title
Revenue Cycle Manager
Phone
(614) 235-5555

Specialties & licenses 1

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

Addresses

Primary practice location

2365 Innis Rd
Columbus, OH 43224-3730

Mailing address

PO Box 632127
Cincinnati, OH 45263-2127
Phone (614) 235-5555

Other names 1

  • Capital Park Family Health Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080124000272 OH Part A Provider - Federally Qualified Health Center (FQHC) 7416039839 Practice locations: Columbus, OH
O20080903000159 OH Part B Supplier - Public Health/Welfare Agency 7416039839 Receives reassigned benefits from 55 practitioners
5 other NPIs on this enrollment
Practice locations: Canal Winchester, OH; Columbus, OH; Westerville, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1275714289. Details of each certification follow.

Federally qualified health center certification: CCN 361889

Legal name
HEART OF OHIO FAMILY HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 6, 2004
Last certification
Jul 6, 2004
Ownership / control type
For profit – partnership
Most recent change of ownership
Nov 1, 2007 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Nov 1, 2007 in OH
Enrollment address
2365 Innis Rd
Columbus, OH 43224-3730
Related CCNs
361889

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 5

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

National Provider Directory

National Provider Directory
Tax ID family
Heart of Ohio Family Health11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

5969 E Broad St
Ste 306
Columbus, OH 43213
Phone (614) 228-0768

675 S Yearling Rd
Ste 100
Whitehall, OH 43213
Phone (614) 235-5555

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Nathaniel Stewart Individual Corporate DirectorBoard Member Aug 1, 2016
Terry D Anderson Individual Corporate DirectorBoard Member Dec 14, 2011
Rita Corbin Individual Corporate DirectorBoard Member Feb 27, 2008
Patricia Dawkins Individual Corporate DirectorBoard Member Aug 22, 2012
Rodirick Dye Individual Corporate OfficerBoard Member Jun 1, 2016
Corporate DirectorBoard Member Jun 1, 2016
Yammah Morgan Individual Corporate OfficerCoo Aug 1, 2017
W-2 Managing EmployeeCoo Aug 1, 2017
Gloria Coyan Individual Corporate DirectorBoard Member Dec 1, 2015
Mohammed Buhari Mohammed Individual Corporate OfficerCeo Apr 1, 2018
W-2 Managing EmployeeCeo Apr 1, 2018

Practitioners & affiliated clinicians

Practitioners 56

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 56

NPI Registry JSON

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1275714289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632127",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632127",
            "telephone_number": "614-235-5555",
            "fax_number": "614-536-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 INNIS RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432243730",
            "telephone_number": "614-416-4325",
            "fax_number": "614-416-4320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART OF OHIO FAMILY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-19",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "BOND",
        "authorized_official_first_name": "LASHONDA",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "614-235-5555"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capital Park Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Capital Park Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.