Lincoln Community Health Center Incorporated

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

LINCOLN COMMUNITY HEALTH CENTER INCORPORATED

Doing business as

Live Well Primary Care Clinic

Practice address

3901 N Roxboro St Ste 101
Durham, NC 27704-2181

Phone

(919) 296-1758

NPI assigned

Aug 14, 2014

Last updated

Jul 28, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

LINCOLN COMMUNITY HEALTH CENTER INCORPORATEDAs reported in NPPES

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

Addresses

Other names 1

• Live Well Primary Care Clinic Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801295936. Details of each certification follow.

• CCN 341031 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 341031

Legal name

LIVE WELL NORTH DURHAM MEDICAL PARK

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jul 14, 2015

Last certification

Jul 14, 2015

Ownership / control type

For profit – corporation

Most recent change of ownership

Aug 31, 2024 (1 total)

Facility address

3901 North Roxboro Street Ste 101
Durham, NC 27704

Part of

Lincoln Community Healt

Locations

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658966400000",
    "number": "1801295936",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 N ROXBORO ST STE 101",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042181",
            "telephone_number": "919-296-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN COMMUNITY HEALTH CENTER INCORPORATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LINCOLN COMMUNITY HEALTH CENTER INCORPORATED",
        "enumeration_date": "2014-08-14",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Live Well Primary Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Live Well Primary Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lincoln Community Health Center Incorporated (Holton Clinic)
• Lincoln Community Health Center Incorporated (Lincoln Community Health Center Pharmacy)
• Lincoln Community Health Center Incorporated (Lyon Park Clinic)
• Lincoln Community Health Center Incorporated (John H Lucas Sr Wellness Center)
• Lincoln Community Health Center Incorporated (Walltown Clinic)
• Lincoln Community Health Center Incorporated (Lincoln CHC-Durham County Human Services)
• Lincoln Community Health Center Incorporated (Health Care for the Homeless Program)
• Allison Lindgren
• Kenneth T Lindley, MD
• Lauren Stone Lindner, MPH, MSN, AGPCNP-BC

• Federally Qualified Health Center (FQHC) in Durham, NC
• Providers in Durham, NC by specialty
• Federally Qualified Health Center (FQHC) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.