NPIMap

Organization Active NPI

Ammonoosuc Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Woodsville, NH
National Provider Identifier
1437376209
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
AMMONOOSUC COMMUNITY HEALTH SERVICES, INC.
Doing business as
Ammonoosuc Community Health Services, Inc.
Practice address
79 Swiftwater Rd
Woodsville, NH 03785-1447
Phone
(603) 747-3740
Fax
(603) 747-0416
NPI assigned
Apr 20, 2007
Last updated
Sep 8, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
AMMONOOSUC COMMUNITY HEALTH SERVICES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Authorized official

Name
Mr. Edward Shanshala II
Title
Chief Executive Officer
Phone
(603) 444-8223

Specialties & licenses 1

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

Addresses

Primary practice location

79 Swiftwater Rd
Woodsville, NH 03785-1447

Mailing address

25 Mount Eustis Rd
Littleton, NH 03561-3712
Phone (603) 444-2464

Other identifiers 1

IdentifierTypeStateIssuer
80301805MedicaidNH

Other names 1

  • Ammonoosuc Community Health Services, Inc. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080228000539 NH Part A Provider - Federally Qualified Health Center (FQHC) 1052361664 Practice locations: Woodsville, NH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1437376209. Details of each certification follow.

Federally qualified health center certification: CCN 301805

Legal name
AMMONOOSUC COMMUNITY HEALTH SERVICES, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 1, 1995
Last certification
Jul 1, 1995
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 24, 1975 in NH
Enrollment address
79 Swiftwater Rd
Woodsville, NH 37851447

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Ammonoosuc Community He7 organizations share this tax ID, including this one
Part of
Ammonoosuc Community He

Other organizations with this tax ID 6

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

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
Mark Secord Individual Corporate DirectorBoard Member Jul 1, 2012
Edward Shanshala Individual Corporate OfficerExecutive Director Feb 22, 2008
W-2 Managing EmployeeExecutive Director Feb 22, 2008
Robert Tortorice Individual Corporate DirectorBoard Member Jul 1, 2017
Tammy Talotta Individual Corporate OfficerCfo Mar 1, 2019
W-2 Managing EmployeeCfo Jul 1, 2015
John Rapoport Individual Corporate DirectorBoard Member Oct 1, 2021
Edward Densmore Individual Corporate DirectorBoard Member Jul 1, 2012
Erik Becker Individual Corporate DirectorBoard Member Jul 1, 2017
Ivy Pearon Individual Corporate DirectorBoard Member Jun 1, 2017

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788825600000",
    "number": "1437376209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MOUNT EUSTIS RD",
            "city": "LITTLETON",
            "state": "NH",
            "postal_code": "035613712",
            "telephone_number": "603-444-2464",
            "fax_number": "603-444-3441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 SWIFTWATER RD",
            "city": "WOODSVILLE",
            "state": "NH",
            "postal_code": "037851447",
            "telephone_number": "603-747-3740",
            "fax_number": "603-747-0416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMMONOOSUC COMMUNITY HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMMONOOSUC COMMUNITY HEALTH SERVICES, INC",
        "enumeration_date": "2007-04-20",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A",
        "authorized_official_last_name": "SHANSHALA",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "603-444-8223",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "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": "80301805",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ammonoosuc Community Health Services, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodsville, NH

Sources for this page

Verify at the official NPI Registry.