Greater Seacoast Community Health
Organization Active NPI Federally Qualified Health Center (FQHC) · Portsmouth, NH
NPI 1881978658 · NPPES record last updated Apr 4, 2018
Key facts
- NPI
- 1881978658
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- GREATER SEACOAST COMMUNITY HEALTH
- Practice address
- 600 Lafayette Rd
Portsmouth, NH 03801-5435 - Phone
- (603) 422-8208
- Fax
- (603) 422-8218
- NPI assigned
- Sep 28, 2011
- Organization subpart
- Yes
- Parent organization (as reported)
- GREATER SEACOAST COMMUNITY HEALTH
Authorized official
- Name
- Kimberly Garca
- Title
- Billing Manager
- Phone
- (603) 812-0833
Owners & managing parties with NPI records 2
-
Mathurin M Malby, MD
-
Jeffrey M Segil, M.D.
Other NPIs on the same Medicare enrollment 6
Other NPIs with the same Medicare PAC ID 7
Corporate family (same tax ID) 13
Practitioners 38
-
Angela Gay Demien, PA-C
-
Emily Follo, MD
-
Kathryn Carlson, LICSW
-
Kelly Faul, APRN
-
Karen L Frarie, M.S.W.
-
Marian M Hallowell, LICSW
-
Allison Hansen, MPAS, PA-C
-
Elizabeth I Harrison, APRN
-
Sonya Layla Hovsepian, M.D.
-
Melissa Keefe, APRN
-
Charity Rae Lafrance, LCMHC
-
David Lunianski, DO
-
Maria Alejandra Martin, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NH
Federally qualified health center certification: CCN 301826
- Legal name
- GREATER SEACOAST COMMUNITY HEALTH
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Apr 3, 2012
- Last certification
- Apr 3, 2012
- Ownership / control type
- For profit – corporation
- Most recent change of ownership
- Jan 1, 2018 (1 total)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Aug 18, 1971 in NH
- Enrollment address
- 600 Lafayette Rd
Portsmouth, NH 38015435
All disclosed owners & managing parties 22
| Name | Role | Since | Share |
|---|---|---|---|
| Yulia Rothenberg |
Corporate Director |
Jan 1, 2018 | |
| Jo Jordan |
Corporate Director |
Jan 1, 2018 | |
| Allison Neal |
Corporate Director |
Jan 1, 2018 | |
| Michael Burke |
Corporate Director |
Jan 1, 2018 | |
| Jennifer Glidden |
Corporate Director |
Jan 1, 2018 | |
| Karin Barndollar |
Corporate Director |
Jan 1, 2018 | |
| Jeffrey M Segil |
Corporate Director |
Jan 1, 2018 | |
| Thomas Newbold |
Corporate Director |
Jan 1, 2018 | |
| Janet M Laatsch |
Corporate Officer |
Jan 1, 2018 | |
| Mark Boulanger |
Corporate Director |
Jan 1, 2018 | |
| Valerie Goodwin |
Corporate Director |
Jan 1, 2018 | |
| Peter Whitman |
Corporate Director |
Jan 1, 2018 | |
| Kimberly a Garca |
W-2 Managing Employee |
Jan 1, 2018 | |
| Mathurin M Malby |
Corporate Director |
Jan 1, 2018 | |
| Lisa Donovan Hall |
Corporate Director |
Jan 1, 2018 | |
| Kathy Scheu |
Corporate Director |
Jan 1, 2018 | |
| Mary Zygala-Schleyer |
Corporate Director |
Jan 1, 2018 | |
| Donald Chick |
Corporate Director |
Jan 1, 2018 | |
| Barbara Henry |
Corporate Director |
Jan 1, 2018 | |
| David Staples |
Corporate Director |
Jan 1, 2018 | |
| Erin Ross |
Corporate Officer |
Jan 1, 2018 | |
| Linda Sanborn |
Corporate Director |
Jan 1, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040809000966 | NH | Part B Supplier - Clinic/Group Practice | 2769454974 |
Receives reassigned benefits from 51 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Portsmouth, NH; Somersworth, NH |
| O20180402001902 | NH | Part a Provider - Federally Qualified Health Center (FQHC) | 2769454974 | Practice locations: Portsmouth, NH |
National Provider Directory
- Tax ID family
- Avis Goodwin Community
- Part of
- Avis Goodwin Community
Locations
600 Lafayette Rd
Portsmouth, NH 03801
Phone (603) 422-8208
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
600 Lafayette Rd
Portsmouth, NH 03801-5435
Mailing address
311 Route 108
Somersworth, NH 03878-1522
Phone (603) 422-8208
Other names
- Families First Health & Support Center
Other providers in Portsmouth, NH
- Greater Seacoast Community Health
- Greater Seacoast Community Health
- Greater Seacoast Community Health
- Greater Seacoast Community Health
- Greater Seacoast Community Health
- Melanie Green
- Greengard Center for Autism
- Joshua L Greenspan
- Marc A Greer
- Gretchen L. Estes, Med, Lcmhc, PLLC
All providers in Portsmouth, NH · Federally Qualified Health Center (FQHC) in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2018. 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.