NPIMap

Organization Active NPI

Three Lower Counties Community Services, Inc.

Doing business as Chesapeake Health Care

  • Federally Qualified Health Center (FQHC)
  • Princess Anne, MD
National Provider Identifier
1407849920
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
THREE LOWER COUNTIES COMMUNITY SERVICES, INC.
Doing business as
Chesapeake Health Care
Practice address
12165 Elm St
Princess Anne, MD 21853-1358
Phone
(410) 651-5151
Fax
(410) 651-4256
NPI assigned
Aug 30, 2005
Last updated
Aug 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Authorized official

Name
Mr. Brian E Holland
Title
President & Ceo
Phone
(410) 749-1015

Specialties & licenses 1

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

Addresses

Primary practice location

12165 Elm St
Princess Anne, MD 21853-1358

Mailing address

PO Box 1978
Salisbury, MD 21802-1978
Phone (410) 749-1015

Other identifiers 1

IdentifierTypeStateIssuer
288504201MedicaidMD

Other names 1

  • Chesapeake Health Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100331000553 MD Part A Provider - Federally Qualified Health Center (FQHC) 3678484300 Practice locations: Princess Anne, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407849920. Details of each certification follow.

Federally qualified health center certification: CCN 211877

Legal name
THREE LOWER COUNTIES COMMUNITY SERVICES INC
Doing business as
CHESAPEAKE HEALTH CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 31, 2010
Last certification
Mar 31, 2010
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 28, 1994 in MD
Enrollment address
12165 Elm St
Princess Anne, MD 21853-1358

Other NPIs with the same Medicare PAC ID 23

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

View all 23

National Provider Directory

National Provider Directory
Tax ID family
Abdul K Garuba37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

View all 36

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Kathleen Crossan Individual Corporate DirectorBoard Member Apr 7, 2008
Byron Jennings Individual Corporate OfficerChief Medical Officer Jan 12, 2018
Paula D. Brown Individual Corporate DirectorBoard Member Mar 31, 2015
D'Arcy Nicole Green Individual Corporate DirectorVice President Apr 7, 2008
Jennifer Swanton Individual Corporate DirectorBoard Member Aug 30, 2016
Everett L. McCabe Individual Corporate DirectorBoard Member Dec 20, 2016
Joshua L Boston Individual Corporate OfficerChief Operations Officer Feb 1, 2020
Lauren Taylor Individual Corporate DirectorSecretary Apr 7, 2008
Chris Labarge Individual Corporate DirectorPresident Apr 7, 2008
Ernest D. Camarena Individual Corporate DirectorBoard Member Jan 28, 2014
Nancy a Baker Individual Corporate OfficerChief Nursing Officer Feb 1, 2020
Keisha Evans Individual Corporate Director Feb 27, 2018
Brian E Holland Individual Corporate Officer Jun 1, 2018
W-2 Managing Employee Jun 1, 2018
Operational/Managerial Control Jun 1, 2018

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 6

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

FacilityTypeRoleSince
Chesapeake Health CarePrincess Anne, MD, CCN 211935 Federally qualified health center Operational/Managerial Control Jun 1, 2018
Chesapeake Health CareBerlin, MD, CCN 211937 Federally qualified health center Operational/Managerial Control Feb 28, 1994
Chesapeake Health CareSalisbury, MD, CCN 211941 Federally qualified health center Operational/Managerial Control Feb 28, 1994
Chesapeake Health CarePocomoke City, MD, CCN 211943 Federally qualified health center Operational/Managerial Control Feb 28, 1994
Chesapeake Health CareSalisbury, MD, CCN 211010 Federally qualified health center Operational/Managerial Control Feb 28, 1994
Chesapeake Health CareBerlin, MD, CCN 211025 Federally qualified health center Operational/Managerial Control Feb 28, 1994

Owned or controlled facilities with NPI records 6

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

Practitioners & affiliated clinicians

Practitioners 51

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 51

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754611200000",
    "number": "1407849920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1978",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218021978",
            "telephone_number": "410-749-1015",
            "fax_number": "410-749-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12165 ELM ST",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "218531358",
            "telephone_number": "410-651-5151",
            "fax_number": "410-651-4256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE LOWER COUNTIES COMMUNITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-30",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "410-749-1015",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288504201",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chesapeake Health Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Chesapeake Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Princess Anne, MD

Sources for this page

Verify at the official NPI Registry.