NPIMap

Organization Active NPI

Family Health Services of Darke County Inc

Doing business as Family Health

  • Federally Qualified Health Center (FQHC)
  • Greenville, OH
National Provider Identifier
1366419293
Registry record updated Nov 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FAMILY HEALTH SERVICES OF DARKE COUNTY INC
Doing business as
Family Health
Practice address
5735 Meeker Rd
Greenville, OH 45331-1180
Phone
(937) 548-3806
Fax
(937) 548-3552
NPI assigned
Feb 28, 2006
Last updated
Nov 3, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2009

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

Authorized official

Name
Ms. Jean E Young
Title
Assistant Administrator
Phone
(937) 548-3806

Specialties & licenses 1

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

Addresses

Primary practice location

5735 Meeker Rd
Greenville, OH 45331-1180

Mailing address

5735 Meeker Rd
Greenville, OH 45331-1180
Phone (937) 548-3806

Other names 1

  • Family Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040427000749 OH Part B Supplier - Clinic/Group Practice 5698762235 Receives reassigned benefits from 82 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Versailles, OH; Union City, OH; Greenville, OH; New Madison, OH; Arcanum, OH
O20091210000403 OH Part A Provider - Federally Qualified Health Center (FQHC) 5698762235 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Versailles, OH
O20100816000898 OH Part A Provider - Federally Qualified Health Center (FQHC) 5698762235 Practice locations: Greenville, OH

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1366419293. Details of each certification follow.

Federally qualified health center certification: CCN 361959

Legal name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 10, 2009
Last certification
Dec 10, 2009
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jan 16, 1973 in OH
Enrollment address
10484 Kley Rd
Versailles, OH 45380-9561

Federally qualified health center certification: CCN 361840

Legal name
FAMILY HEALTH SERVICES OF DARKE COUNTY, INC.
Doing business as
FAMILY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 16, 1973 in OH
Enrollment address
5735 Meeker Rd
Greenville, OH 45331-1180

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 11

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

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory

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
Crysta Bloomingdale Individual Corporate Director Jul 30, 2018
Corporate DirectorBoard Member Jul 30, 2018
Austie M Auker Individual Corporate OfficerCfo Jul 23, 2014
W-2 Managing EmployeeCfo Jul 23, 2014
Corporate DirectorFinance Director Jun 25, 2012
W-2 Managing EmployeeFinance Director Jun 25, 2012
Alan Ayette Individual Corporate DirectorBoard Member Jul 10, 2023
Michael Robert Maher Individual Corporate DirectorBoard Member Jul 31, 2017
Corporate DirectorBoard Member Oct 20, 2009
Sonja Etzell Individual Corporate DirectorBoard Member Apr 25, 2016
Corporate DirectorBoard Member Jul 27, 2015
Joy Greer Individual Corporate DirectorBoard Member Aug 5, 2019
Cassidy Helman Individual Corporate DirectorBoard Member Aug 1, 2022
Kathy S O'Dell Individual Corporate DirectorBoard Member Jun 23, 2014
Corporate DirectorBoard Member Oct 20, 2009
Jared M Pollick Individual Corporate OfficerCeo May 22, 2020
W-2 Managing EmployeeCeo May 22, 2020
Corporate DirectorExecutive Director May 22, 2020 100%
W-2 Managing EmployeeExecutive Director May 22, 2020 100%
John Warner Individual Corporate DirectorBoard Member Aug 1, 2022
Thomas Treon Individual Corporate DirectorBoard Member Jul 30, 2018
Scott C Clum Individual Corporate DirectorBoard Member Jul 25, 2016
Corporate DirectorBoard Member Oct 20, 2009

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Comprehensive Health NetworkGreenville, OH, CCN 367444 Home health agency 5% Or Greater Direct Ownership Interest May 19, 2009

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 53

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 53

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257206400000",
    "number": "1366419293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5735 MEEKER RD",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "453311180",
            "telephone_number": "937-548-3806",
            "fax_number": "937-548-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5735 MEEKER RD",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "453311180",
            "telephone_number": "937-548-3806",
            "fax_number": "937-548-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH SERVICES OF DARKE COUNTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-28",
        "last_updated": "2009-11-03",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ASSISTANT ADMINISTRATOR",
        "authorized_official_telephone_number": "937-548-3806",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, OH

Sources for this page

Verify at the official NPI Registry.