NPIMap

Organization Active NPI

Ohio North East Health Systems, Inc

  • Federally Qualified Health Center (FQHC)
  • Newton Falls, OH
National Provider Identifier
1477920205
Registry record updated Dec 14, 2017
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
Practice address
175 E Broad St
Newton Falls, OH 44444-1708
Phone
(330) 747-9551
Fax
(330) 884-6120
NPI assigned
Aug 27, 2015
Last updated
Dec 14, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2017

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

Authorized official

Name
Ronald DwinnellsNPI 1902893142
Title
Ceo
Phone
(330) 747-9551

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Nurse Practitioner 363L00000X
Mental Health Counselor 101YM0800X
Dentist 122300000X
Dental Hygienist 124Q00000X
Family Medicine Physician 207Q00000X
Gynecology Physician 207VG0400X
Podiatrist 213E00000X

Addresses

Primary practice location

175 E Broad St
Newton Falls, OH 44444-1708

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
0166559MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160204000217 OH Part A Provider - Federally Qualified Health Center (FQHC) 1951395086 Practice locations: Newton Falls, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477920205. Details of each certification follow.

Federally qualified health center certification: CCN 361098

Legal name
OHIO NORTH EAST HEALTH SYSTEMS INC
Doing business as
FALLS FAMILY CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 4, 2016
Last certification
Feb 4, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 1, 1989 in OH
Enrollment address
175 E Broad St
Newton Falls, OH 44444-1708

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 11

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 Corporate DirectorBoard Member Apr 27, 2021
Dan Rupp Individual Corporate DirectorBoard Member Jul 30, 2018
Dennis Kuhns Individual Corporate DirectorBoard Chairman Jul 30, 2018
Judy Eiland Individual Corporate DirectorBoard Member Oct 24, 2017
Susan Montalbano Individual W-2 Managing EmployeeCredentialing Coordinator Aug 4, 2014
Ronald Dwinnells Individual Corporate OfficerCeo Jul 18, 1994
Tanya Murphy Individual Corporate DirectorBoard Member Nov 29, 2016
Damon Dohar Individual Corporate DirectorBoard Member Aug 29, 2017
Victor Wan-Tatah Individual Corporate DirectorBoard Member Nov 1, 2002
Tammy Parteleno Individual Corporate DirectorBoard Member Jul 25, 2017
Patricia Rupp Individual Corporate DirectorBoard Member Jul 30, 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 2

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": "1440633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513209600000",
    "number": "1477920205",
    "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": "330-884-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E BROAD ST",
            "city": "NEWTON FALLS",
            "state": "OH",
            "postal_code": "444441708",
            "telephone_number": "330-747-9551",
            "fax_number": "330-884-6120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO NORTH EAST HEALTH SYSTEMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-27",
        "last_updated": "2017-12-14",
        "status": "A",
        "authorized_official_last_name": "DWINNELLS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "330-747-9551"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0166559",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton Falls, OH

Sources for this page

Verify at the official NPI Registry.