NPIMap

Organization Active NPI

Lincoln Community Health Center Incorporated

  • Federally Qualified Health Center (FQHC)
  • Durham, NC
National Provider Identifier
1649210279
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LINCOLN COMMUNITY HEALTH CENTER INCORPORATED
Practice address
3727 Fayetteville St
Durham, NC 27707-4718
Phone
(919) 956-4519
Fax
(919) 688-3288
NPI assigned
Jun 8, 2006
Organization subpart
Yes
Parent organization
LINCOLN COMMUNITY HEALTH CENTER INCORPORATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Authorized official

Name
Claretta Foye
Title
Chief Executive Officer
Phone
(919) 956-4022

Specialties & licenses 1

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

Addresses

Primary practice location

3727 Fayetteville St
Durham, NC 27707-4718

Mailing address

PO Box 52119
Durham, NC 27717-2119
Phone (919) 956-4000

Other identifiers 3

IdentifierTypeStateIssuer
344500AMedicaidNC
03055OtherNCNC BC/BS ID NUMBER
344500CMedicaidNC

Other names 1

  • JOHN H LUCAS SR WELLNESS CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041101000593 NC Part A Provider - Federally Qualified Health Center (FQHC) 4587642590 1 other NPI on this enrollment
Practice locations: Durham, NC

Other NPIs with the same Medicare PAC ID 7

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

Federally qualified health center certification: CCN 341883

Legal name
LINCOLN COMMUNITY HEALTH CENTER INCORPORATED
Doing business as
JOHN H. LUCAS WELLNESS CENTER AT HILLSIDE HIGH SCHOOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 9, 2004
Last certification
Dec 9, 2004
Ownership / control type
Non-profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 25, 1972 in NC
Enrollment address
3727 Fayetteville St
Durham, NC 27707-4718

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Lincoln Comm Health Ctr8 organizations share this tax ID, including this one
Part of
Lincoln Comm Health Ctr

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Ana Velasquez Individual Corporate DirectorVolunteer Board Member Dec 20, 2020
Claudia Gabiota Zuniga Individual Corporate DirectorVolunteer Board Member Jul 1, 2022
Angel Vick-Lewis Individual Corporate DirectorVolunteer Board Member Mar 1, 2020
Kristin E Ito Individual Corporate OfficerCmo Apr 23, 2021
W-2 Managing EmployeeCmo Apr 23, 2021
Maggie Clapp Individual Corporate DirectorVolunteer Board Member Oct 1, 2024
Ronald Williams Individual Corporate DirectorVolunteer Board Member Feb 1, 2019
Elizabeth Stevens Individual Corporate DirectorVolunteer Board Member Nov 1, 2022
William Paul Seagroves Individual Corporate OfficerCfo Jun 16, 2014
W-2 Managing EmployeeCfo Jun 16, 2014
Ricky Leon Hart Individual Corporate DirectorVolunteer Board Member Mar 1, 2025
Claretta Foye Individual Corporate OfficerCoo Jan 1, 2010
W-2 Managing EmployeeCoo Jan 1, 2010
Valarie Jarvis Individual Corporate DirectorVolunteer Board Member Oct 1, 2024
Denise Lunsford Individual Corporate DirectorVolunteer Board Member Mar 1, 2025
Wendy Jacobs Individual Corporate DirectorVolunteer Board Member Mar 1, 2021
Dexter Nolley Individual Corporate DirectorVolunteer Board Member Nov 1, 2019
Jose Martinez Beltran Individual Corporate DirectorVolunteer Board Member Oct 1, 2023
Carlotta Jordan Individual Corporate DirectorVolunteer Board Member Jan 1, 2018
Gregory Stephens Individual Corporate DirectorVolunteer Board Member Jul 1, 2024
Frank Whitehead Jr. Individual Corporate DirectorVolunteer Board Member Jul 1, 2024

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 2

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

FacilityTypeRoleSince
Lincoln Community Health Center IncorporatedDurham, NC, CCN 341885 Federally qualified health center Operational/Managerial Control May 25, 1972
Holton ClinicDurham, NC, CCN 341950 Federally qualified health center Operational/Managerial Control Jul 1, 2009

Owned or controlled facilities with NPI records 2

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

Practitioners 51

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

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658966400000",
    "number": "1649210279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52119",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277172119",
            "telephone_number": "919-956-4000",
            "fax_number": "919-956-4535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3727 FAYETTEVILLE ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277074718",
            "telephone_number": "919-956-4519",
            "fax_number": "919-688-3288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN COMMUNITY HEALTH CENTER INCORPORATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LINCOLN COMMUNITY HEALTH CENTER INCORPORATED",
        "enumeration_date": "2006-06-08",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A",
        "authorized_official_last_name": "FOYE",
        "authorized_official_first_name": "CLARETTA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "919-956-4022"
    },
    "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": "344500A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BC/BS ID NUMBER",
            "identifier": "03055",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344500C",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JOHN H LUCAS SR WELLNESS CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JOHN H LUCAS SR WELLNESS CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.