Ironton & Lawrence County Area Community Action Organization
Organization Active NPI Federally Qualified Health Center (FQHC) · Coal Grove, OH
NPI 1851461644 · NPPES record last updated Jan 3, 2014
Key facts
- NPI
- 1851461644
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- IRONTON & LAWRENCE COUNTY AREA COMMUNITY ACTION ORGANIZATION
- Practice address
- 223 Carlton Davidson LN
Coal Grove, OH 45638-2924 - Phone
- (740) 532-3048
- Fax
- (740) 532-0319
- NPI assigned
- Nov 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Nancy J Lewis, CPNP
- Title
- Director of Health Services
- Phone
- (740) 532-3534
Other NPIs on the same Medicare enrollment 7
Practitioners 5
-
David Alan Apgar, DO, CMD
-
Vinod Miriyala, DDS, BDS, MPH
-
Sarah Setran, PSYD
-
Rizwan Ali, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100325000713 | OH | Part B Supplier - Public Health/Welfare Agency | 8820902497 |
Receives reassigned benefits from 28 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Chesapeake, OH; South Point, OH |
National Provider Directory
Locations
424 Lawrence St
Ste 102
Ironton, OH 45638
55 Township Road 508 E
South Point, OH 45680
Phone (740) 377-2712
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
223 Carlton Davidson LN
Coal Grove, OH 45638-2924
Mailing address
305 N 5TH St
Ironton, OH 45638-1578
Phone (740) 532-3534
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100113430 | Medicaid | KY | |
| 3810017136 | Medicaid | WV | |
| 0949291 | Medicaid | OH |
Other names
- KEMP FAMILY MEDICAL CENTER
Other providers in Coal Grove, OH
- Georgann C Holbrook
- Amanda P Holston
- Stacy Howard
- Travis Hoylman
- Ironton & Lawrence County Area Community Action Organization
- Lisa Jackson
- Kelly Jenkins
- Ian Jennings
- Kayla Jean Kelley
- Patrick C Kelley
All providers in Coal Grove, OH · Federally Qualified Health Center (FQHC) in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2014. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.