NPIMap

Organization Active NPI

Ohio North East Health Systems Inc

Doing business as Youngstown Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Youngstown, OH
National Provider Identifier
1306835210
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
OHIO NORTH EAST HEALTH SYSTEMS INC
Doing business as
Youngstown Community Health Center
Practice address
726 Wick Ave
Youngstown, OH 44505-2827
Phone
(330) 747-9551
Fax
(330) 747-9552
NPI assigned
Oct 14, 2005
Last updated
Oct 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Authorized official

Name
Mr. Ronald Dwinwells, MD
Title
Ceo
Phone
(330) 747-9551

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Clinical Neuropsychologist 103G00000X NU
Clinical Social Worker 1041C0700X NU
Dentist 122300000X NU
Family Medicine Physician 207Q00000X NU
Obstetrics & Gynecology Physician 207V00000X NU
Podiatrist 213E00000X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU

Addresses

Primary practice location

726 Wick Ave
Youngstown, OH 44505-2827

Mailing address

726 Wick Ave
Youngstown, OH 44505-2827
Phone (330) 747-9551

Other identifiers 1

IdentifierTypeStateIssuer
0836699MedicaidOH

Other names 1

  • Youngstown Community Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110314000860 OH Part A Provider - Federally Qualified Health Center (FQHC) 1951395086 Practice locations: Youngstown, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306835210. Details of each certification follow.

Federally qualified health center certification: CCN 361848

Legal name
OHIO NORTH EAST HEALTH SYSTEMS INC
Doing business as
YOUNGSTOWN COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1992
Last certification
Oct 1, 1992
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Feb 23, 1989 in OH
Enrollment address
726 Wick Ave
Youngstown, OH 44505-2827

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Ohio North East Health Systems Inc23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
William Thornton Individual OtherBoard Member Apr 27, 2021
Dan Rupp Individual OtherBoard Member Jul 30, 2018
Dennis Kuhns Individual OtherBoard Chairman Jul 30, 2018
Judy Eiland Individual OtherBoard Member Oct 24, 2017
Susan Montalbano Individual W-2 Managing Employee Aug 4, 2014
Ronald Dwinnells Individual Corporate OfficerCeo Jan 10, 2010
Tanya Murphy Individual OtherBoard Member Nov 29, 2016
Damon Dohar Individual OtherBoard Member Jul 30, 2018
Victor Wan-Tatah Individual Corporate Director Jan 10, 2010
Tammy Parteleno Individual OtherBoard Member Jul 25, 2017
Patricia Rupp Individual OtherBoard Member Jul 30, 2018
Rose Marie Pirone Individual OtherBoard Member Dec 11, 2018

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1129248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1306835210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 WICK AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445052827",
            "telephone_number": "330-747-9551",
            "fax_number": "330-747-9552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 WICK AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445052827",
            "telephone_number": "330-747-9551",
            "fax_number": "330-747-9552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO NORTH EAST HEALTH SYSTEMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-14",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "DWINWELLS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "330-747-9551",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0836699",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Youngstown Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.