Union Community Care
Organization Active NPI Federally Qualified Health Center (FQHC) · Lebanon, PA
NPI 1831836816 · NPPES record last updated Jul 22, 2024
Key facts
- NPI
- 1831836816
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- UNION COMMUNITY CARE
- Practice address
- 960 Church St
Lebanon, PA 17046 - Phone
- (717) 299-6371
- Fax
- (717) 325-8057
- NPI assigned
- May 19, 2022
- Organization subpart
- No
Authorized official
- Name
- Alisa Maria Jones
- Title
- President and Ceo
- Phone
- (717) 945-1551
Owners & managing parties with NPI records 1
Owned or controlled facilities with NPI records 4
Other NPIs on the same Medicare enrollment 20
Other NPIs with the same Medicare PAC ID 21
Corporate family (same tax ID) 23
Practitioners 26
-
Tuyet-Nga Q Vu, D.O.
-
Erica Leigh Coulter, M.D.
-
Douglas E Leaman, M.D.
-
Mattie Lefever, RDN
-
Sabrina Aileen Milhous, M.D.
-
Peter G Moyer, M.D.
-
John D Perez, MA
-
Juan A Pineda, LCSW
-
Madhumita Sadhukhan, M.D.
-
Gwendolyn Shelly, R.D.
-
Robert J Shelly, MD
-
Peter C Smith, DPM
-
Tara M Wiker, LCSW
-
Kavita Vasu, M.D.
-
Kristen M Harker, CRNP CNM
-
Shaun Michael Jay, D.C., M.S.
-
Shannon Corcoran Love, LCPC
-
Neri Ayllon-Vergara, CRNP
-
Erica Joy Lehman, CRNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in PA
Federally qualified health center certification: CCN 731982
- Legal name
- UNION COMMUNITY CARE
- Doing business as
- UNION COMMUNITY CARE
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jun 10, 2022
- Last certification
- Jun 10, 2022
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Oct 1, 1973 in PA
- Enrollment address
- 960 Church St
Lebanon, PA 17046-4656
All disclosed owners & managing parties 23
| Name | Role | Since | Share |
|---|---|---|---|
| Cesar Liriano |
Corporate Director |
May 23, 2022 | |
| Rodney Redcay |
Corporate Director |
May 23, 2022 | |
| Cindy Stewart |
Corporate Director |
May 23, 2022 | |
| James Reichenbach |
Corporate Officer |
May 23, 2022 | |
| W-2 Managing Employee |
May 23, 2022 | ||
| Operational/Managerial Control |
May 23, 2022 | ||
| Cornell Wilson |
Corporate Director |
May 23, 2022 | |
| Daniel Uzupis |
Corporate Officer |
Dec 8, 2023 | |
| W-2 Managing Employee |
Dec 8, 2023 | ||
| Operational/Managerial Control |
Dec 8, 2023 | ||
| Yolanda Rice |
Corporate Director |
May 23, 2022 | |
| Eric Blum |
Corporate Officer |
Jul 28, 2023 | |
| Operational/Managerial Control |
Jul 28, 2023 | ||
| Brian Burgess |
Corporate Director |
May 23, 2022 | |
| Alisa M Jones |
Corporate Officer |
May 23, 2022 | 100% |
| W-2 Managing Employee |
May 23, 2022 | 100% | |
| Operational/Managerial Control |
May 23, 2022 | 100% | |
| Margaret Costella |
Corporate Director |
Jul 28, 2023 | |
| Jennifer Black |
Corporate Officer |
Dec 8, 2023 | |
| W-2 Managing Employee |
Dec 8, 2023 | ||
| Operational/Managerial Control |
Dec 8, 2023 | ||
| Anne-Marie Derrico |
Corporate Officer |
May 23, 2022 | |
| W-2 Managing Employee |
May 23, 2022 | ||
| Operational/Managerial Control |
May 23, 2022 | ||
| John Carpenter |
Corporate Director |
Apr 5, 2023 | |
| Denise Elliott |
Corporate Director |
May 23, 2022 | |
| Maribel Torres |
Corporate Director |
Apr 5, 2023 | |
| Jannat Veras |
Corporate Director |
Mar 1, 2021 | |
| Jacqueline McCain |
Corporate Director |
May 23, 2022 | |
| Madeline Bermudez |
Corporate Director |
Apr 5, 2023 | |
| Nicole Specht |
Corporate Officer |
May 23, 2022 | |
| W-2 Managing Employee |
May 23, 2022 | ||
| Operational/Managerial Control |
May 23, 2022 | ||
| David Kreider |
Corporate Director |
May 23, 2022 | |
| Michael Cormany |
Corporate Director |
May 23, 2022 | |
| James Cox |
Corporate Director |
May 23, 2022 |
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Union Community Care |
Federally qualified health center | Operational/Managerial Control (100%) | Mar 1, 2021 |
| Union Community Care |
Federally qualified health center | Operational/Managerial Control (100%) | Mar 1, 2021 |
| Union Community Care |
Federally qualified health center | Operational/Managerial Control (100%) | Mar 1, 2021 |
| Union Community Care |
Federally qualified health center | Operational/Managerial Control (100%) | Jul 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040608000860 | PA | Part B Supplier - Clinic/Group Practice | 8123914322 |
Receives reassigned benefits from 97 practitioners 21 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lancaster, PA; Lebanon, PA; New Holland, PA; Ephrata, PA; Denver, PA; Columbia, PA |
| O20220606000894 | PA | Part a Provider - Federally Qualified Health Center (FQHC) | 8123914322 | Practice locations: Lebanon, PA |
National Provider Directory
- Tax ID family
- Welsh Mountain HLTH CTRS
Locations
584 Springville Rd
New Holland, PA 17557
Phone (717) 354-4711
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
960 Church St
Lebanon, PA 17046
Mailing address
304 N Water St
Lancaster, PA 17603-3374
Phone (717) 299-6372
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1007614190021 | Medicaid | PA |
Other names
- Welsh Mountain Health Centers
Other providers in Lebanon, PA
- Ambreen Umer
- Ashley Elizabeth Unfried
- Union Community Care
- Union Community Care
- Union Community Care
- Union Community Care
- Union Community Care
- Wendy Lynn Updegrove
- Urology Associates of Lebanon, P.C.
- Lauren Jane Usher
All providers in Lebanon, PA · Federally Qualified Health Center (FQHC) in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.