NPIMap

Organization Active NPI

North Side Christian Health Center

  • Federally Qualified Health Center (FQHC)
  • Pittsburgh, PA
National Provider Identifier
1609091578
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NORTH SIDE CHRISTIAN HEALTH CENTER
Practice address
816 Middle St
Pittsburgh, PA 15212-4915
Phone
(412) 321-4001
NPI assigned
Apr 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Authorized official

Name
Winter Epps
Title
Cfo
Phone
(412) 321-4001

Specialties & licenses 1

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

Addresses

Primary practice location

816 Middle St
Pittsburgh, PA 15212-4915

Mailing address

816 Middle St
Pittsburgh, PA 15212-4915
Phone (412) 321-4001

Other identifiers 1

IdentifierTypeStateIssuer
100747115MedicaidPA

Other names 1

  • North Side Christian Health Center Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20030307000051 PA Part A Provider - Federally Qualified Health Center (FQHC) 7012826373 Practice locations: Pittsburgh, PA
O20050420000045 PA Part B Supplier - Clinic/Group Practice 7012826373 Receives reassigned benefits from 11 practitioners
1 other NPI on this enrollment
Practice locations: Pittsburgh, PA
O20090311000079 PA Part A Provider - Federally Qualified Health Center (FQHC) 7012826373 1 other NPI on this enrollment
Practice locations: Pittsburgh, PA

Federally qualified health center certification: CCN 391926

Legal name
NORTH SIDE CHRISTIAN HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 3, 2003
Last certification
Jun 3, 2003
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 29, 1993 in PA
Enrollment address
816 Middle St
Pittsburgh, PA 15212-4915

Federally qualified health center certification: CCN 391987

Legal name
NORTH SIDE CHRISTIAN HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 15, 2009
Last certification
Apr 15, 2009
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 29, 1993 in PA
Enrollment address
525 Mount Pleasant Rd
Pittsburgh, PA 15214-2427

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Locations

525 Mount Pleasant Rd
Pittsburgh, PA 15214
Phone (412) 322-7500

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHEIAA

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
Chris Rosselot Individual Corporate DirectorBoard Member Jan 1, 2022
Corporate Officer Jan 1, 2022
Winter Epps Individual Corporate OfficerCfo Mar 21, 2022
W-2 Managing Employee Sep 1, 2022
Marc Camarata Individual Corporate Director Feb 1, 2012
Corporate Director Apr 13, 2013
Aaron Aldrich Individual Corporate Director Feb 1, 2012
Corporate Director Apr 13, 2013
Bethany Blackburn Individual Corporate OfficerOfficer Sep 1, 2022
W-2 Managing Employee Sep 1, 2022
Corporate DirectorPresident Jan 1, 2022
Deborah Donovan Individual Corporate DirectorBoard Member Jan 1, 2023
Corporate Officer Jan 1, 2022
Courtney Mehalic Individual Corporate DirectorAuthorized Offical Jan 1, 2022
Jessica Price Individual Contracted Managing EmployeeMedical Director Jan 1, 2022
Corporate DirectorMedical Director Aug 21, 2021

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683072000000",
    "number": "1609091578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 MIDDLE ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124915",
            "telephone_number": "412-321-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 MIDDLE ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124915",
            "telephone_number": "412-321-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SIDE CHRISTIAN HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A",
        "authorized_official_last_name": "EPPS",
        "authorized_official_first_name": "WINTER",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "412-321-4001"
    },
    "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": "100747115",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Side Christian Health Center",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "North Side Christian Health Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.