NPIMap

Organization Active NPI

Lorain County Health & Dentistry

  • Federally Qualified Health Center (FQHC)
  • Oberlin, OH
National Provider Identifier
1821464306
Registry record updated Aug 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LORAIN COUNTY HEALTH & DENTISTRY
Practice address
260 South Main Street
Oberlin, OH 44074
Phone
(440) 240-1655
Fax
(440) 240-1663
NPI assigned
Aug 19, 2015
Last updated
Aug 19, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2015

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

Authorized official

Name
Lisa Hemker, CFO
Title
Chief Financial Officer
Phone
(440) 240-1655

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Pediatric Nurse Practitioner 363LP0200X NU
Primary Care Nurse Practitioner 363LP2300X NU
Dentist 122300000X NU
Pediatric Dentistry 1223P0221X NU
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X NU
Family Medicine Physician 207Q00000X NU
Adult Medicine Physician 207QA0505X NU
Internal Medicine Physician 207R00000X NU
Obstetrics & Gynecology Physician 207V00000X NU
Pediatrics Physician 208000000X NU
Podiatrist 213E00000X NU

Addresses

Primary practice location

260 South Main Street
Oberlin, OH 44074

Mailing address

1205 Broadway
Lorain, OH 44052-3409
Phone (440) 240-1655

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160112000230 OH Part A Provider - Federally Qualified Health Center (FQHC) 9234047853 Practice locations: Oberlin, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821464306. Details of each certification follow.

Federally qualified health center certification: CCN 361096

Legal name
LORAIN COUNTY HEALTH & DENTISTRY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 5, 2016
Last certification
Jan 5, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 30, 2001 in OH
Enrollment address
260 S Main St
Oberlin, OH 44074-1773

Other NPIs with the same Medicare PAC ID 9

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

National Provider Directory

National Provider Directory
Tax ID family
Lorain County Health Dentistry26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Locations

260 S Main St
Oberlin, OH 44074

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Tammy B Greber Individual Corporate DirectorBoard Member Sep 20, 2022
Todd H Tilberg Individual Corporate DirectorPresident of Board Sep 23, 2003
David H Hall Individual Corporate DirectorBoard Member Feb 4, 2020
Cathy Heck Individual Corporate DirectorBoard Member Mar 16, 2021
Ben Kosewski Individual Contracted Managing EmployeeCeo Mar 1, 2025
Corporate OfficerCeo Mar 1, 2025
Reuben Figueroa Individual Corporate DirectorBoard Member Feb 24, 2020
Nora McDonald Individual Corporate DirectorBoard Member Jun 21, 2022
Lisa M Hemker Individual Corporate OfficerCfo Nov 23, 2009
W-2 Managing EmployeeCfo Nov 23, 2009
Lisa M Brown Individual Corporate DirectorBoard Member Oct 28, 2013
Katie Kreps Individual Corporate DirectorBoard Member Aug 16, 2022
Nali Ivey Individual Corporate DirectorBoard Member Feb 26, 2002
Melissa Velez Individual Corporate DirectorBoard Member May 19, 2020
Robyn Mwila Individual Corporate DirectorBoard Member Jul 20, 2021

NPI Registry JSON

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439942400000",
    "number": "1821464306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 BROADWAY",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440523409",
            "telephone_number": "440-240-1655",
            "fax_number": "440-240-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 SOUTH MAIN STREET",
            "city": "OBERLIN",
            "state": "OH",
            "postal_code": "44074",
            "telephone_number": "440-240-1655",
            "fax_number": "440-240-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORAIN COUNTY HEALTH & DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-19",
        "last_updated": "2015-08-19",
        "status": "A",
        "authorized_official_last_name": "HEMKER",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "440-240-1655",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oberlin, OH

Sources for this page

Verify at the official NPI Registry.