NPIMap

Organization Active NPI

Greater Seacoast Community Health

  • Federally Qualified Health Center (FQHC)
  • Exeter, NH
National Provider Identifier
1366027609
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GREATER SEACOAST COMMUNITY HEALTH
Practice address
53 Lincoln St
Exeter, NH 03833-3212
Phone
(603) 772-9922
Fax
(603) 953-0066
NPI assigned
Mar 17, 2021
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Kimberly Garca
Title
Patient Account Director
Phone
(603) 749-2346

Owners & managing parties with NPI records 1

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

Other NPIs with the same Medicare PAC ID 7

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

Practitioners 36

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 36

Medicare participation

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

Federally qualified health center certification: CCN 301853

Legal name
GREATER SEACOAST COMMUNITY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 20, 2021
Last certification
Jul 20, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 2018 in NH
Enrollment address
53 Lincoln St
Exeter, NH 38333212

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210420000109 NH Part A Provider - Federally Qualified Health Center (FQHC) 2769454974 Practice locations: Exeter, NH

All disclosed owners & managing parties 15

Medicare enrollment files

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

NameRoleSinceShare
Yulia Rothenberg Individual Corporate DirectorBoard Member Jun 1, 2021
Jo Jordan Individual Corporate DirectorBoard Member Jun 1, 2021
Allison Neal Individual Corporate DirectorBoard Member Jun 1, 2021
Jennifer Glidden Individual Corporate DirectorBoard Secretary Jun 1, 2021
Karin Barndollar Individual Corporate DirectorBoard Member Jun 1, 2021
Jeffrey M Segil Individual Corporate DirectorBoard Member Jun 1, 2021
Janet M Laatsch Individual Corporate DirectorCeo Jun 1, 2021
W-2 Managing EmployeeCeo Jun 1, 2021
Mark Boulanger Individual Corporate DirectorBoard Member Jun 1, 2021
Valerie Goodwin Individual Corporate DirectorBoard Vice Chair Jun 1, 2021
Kimberly a Garca Individual Corporate DirectorPatient Account Director Jun 1, 2021
Kathy Scheu Individual Corporate DirectorBoard Member Jun 1, 2021
Dennis Veilleux Individual Corporate DirectorBoard Treasurer Jun 1, 2021
Donald Chick Individual Corporate DirectorBoard Member Jun 1, 2021
Barbara Henry Individual Corporate DirectorBoard Chair Jun 1, 2021
David Staples Individual Corporate DirectorBoard Member Jun 1, 2021

National Provider Directory

National Provider Directory
Tax ID family
Avis Goodwin Community14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

NPPES NPI Registry

Primary practice location

53 Lincoln St
Exeter, NH 03833-3212

Mailing address

311 Route 108
Somersworth, NH 03878-1522
Phone (603) 749-2346

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 17, 2021.

{
    "created_epoch": "1615939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615939200000",
    "number": "1366027609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 ROUTE 108",
            "city": "SOMERSWORTH",
            "state": "NH",
            "postal_code": "038781522",
            "telephone_number": "603-749-2346",
            "fax_number": "603-953-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 LINCOLN ST",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038333212",
            "telephone_number": "603-772-9922",
            "fax_number": "603-953-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER SEACOAST COMMUNITY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-17",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A",
        "authorized_official_last_name": "GARCA",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PATIENT ACCOUNT DIRECTOR",
        "authorized_official_telephone_number": "603-749-2346"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Exeter, NH

Sources for this page

Verify at the official NPI Registry.