NPIMap

Organization Active NPI

Lincoln County Primary Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hamlin, WV
National Provider Identifier
1942274543
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LINCOLN COUNTY PRIMARY CARE CENTER, INC.
Practice address
7400 Lynn Ave
Hamlin, WV 25523-1138
Phone
(304) 824-5806
Fax
(304) 824-5804
NPI assigned
Feb 13, 2006
Last updated
Mar 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Authorized official

Name
Lisa Leach
Title
Ceo
Phone
(304) 824-5806

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

7400 Lynn Ave
Hamlin, WV 25523-1138

Mailing address

7400 Lynn Ave
Hamlin, WV 25523-1138
Phone (304) 824-5806

Other identifiers 2

IdentifierTypeStateIssuer
0022695001MedicaidWV
CA9760OtherWVPALMETTO GBA RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
O20040415000138 WV Part B Supplier - Public Health/Welfare Agency 6204821879 Receives reassigned benefits from 60 practitioners
7 other NPIs on this enrollment
Practice locations: Branchland, WV; Chapmanville, WV; Delbarton, WV; Gilbert, WV; Hamlin, WV; Logan, WV; Man, WV; Salt Rock, WV
O20060908000457 WV Part A Provider - Federally Qualified Health Center (FQHC) 6204821879 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hamlin, WV
O20060908000461 WV Part A Provider - Federally Qualified Health Center (FQHC) 6204821879 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Griffithsville, WV
O20080111000489 WV Part A Provider - Federally Qualified Health Center (FQHC) 6204821879 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Branchland, WV
O20100929000273 WV Part A Provider - Federally Qualified Health Center (FQHC) 6204821879 Practice locations: Hamlin, WV

NPI to CCN mapping 4

The Medicare certification numbers (CCNs) connected to NPI 1942274543. Details of each certification follow.

Federally qualified health center certification: CCN 511912

Legal name
LINCOLN COUNTY PRIMARY CARE CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 1, 2006
Last certification
Nov 1, 2006
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
Jun 30, 1975 in WV
Enrollment address
81 Lincoln Panther Way
Hamlin, WV 25523-1169

Federally qualified health center certification: CCN 511910

Legal name
LINCOLN COUNTY PRIMARY CARE CENTER INC
Doing business as
DUVAL MIDDLE SCHOOL HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 1, 2006
Last certification
Nov 1, 2006
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
Jun 30, 1975 in WV
Enrollment address
5304 Straight Fork
Griffithsville, WV 25521-9504

Federally qualified health center certification: CCN 511935

Legal name
LINCOLN COUNTY PRIMARY CARE CENTER INC
Doing business as
GUYAN VALLEY WELLNESS CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 26, 2008
Last certification
Feb 26, 2008
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 30, 1975 in WV
Enrollment address
5322 McClellan Highway
Branchland, WV 25506-8725

Federally qualified health center certification: CCN 511852

Legal name
LINCOLN COUNTY PRIMARY CARE CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 1, 1995
Last certification
Jul 1, 1995
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 30, 1975 in WV
Enrollment address
7400 Lynn Ave
Hamlin, WV 25523-1138

Other NPIs with the same Medicare PAC ID 24

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

View all 24

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

267 Midway Rd
Alum Creek, WV 25003
Phone (304) 756-1007

267 Midway Rd
#7400
Alum Creek, WV 25003

5304 Straight Frk
Griffithsville, WV 25521
Phone (304) 524-9241

1 Wildcat Way
#7400
Logan, WV 25601

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Rebecca Farmer Individual Corporate DirectorBoard Member Jul 1, 2017 9.09%
Corporate DirectorBoard Member Jul 1, 2017
Jerry Lawson Individual Corporate DirectorBoard Member Jul 1, 2017 9.09%
Corporate DirectorBoard Member Jul 1, 2017
Letitia Weaver-Scites Individual W-2 Managing EmployeeCredentialing Coordinator Apr 11, 2012
W-2 Managing Employee1St DO/Credentialing Coordinator Apr 11, 2012
Lisa Leach Individual Corporate OfficerCeo Mar 31, 2018
Corporate DirectorCeo Jun 12, 2018
Operational/Managerial ControlCeo Mar 31, 2018
David Boggess Individual Corporate DirectorDirector Jul 1, 2018
Corporate DirectorBoard Member Aug 1, 2018
Corporate DirectorBoard Member Jul 1, 2018
Ollie Hunting Individual Corporate DirectorBoard Member Jul 1, 2014 9.09%
Corporate DirectorBoard Member Jul 1, 2014
Nancy Godby Individual Corporate DirectorBoard Member Jul 1, 2018
Kathryn Lambdin Individual Corporate DirectorBoard Member Jul 1, 2014 9.09%
Corporate DirectorBoard Member Jul 1, 2014
Tab Mathis Individual Corporate DirectorBoard Member Aug 1, 2019
Julia a Barrett Individual W-2 Managing Employee May 5, 1999
W-2 Managing EmployeeCfo/Delegated Official May 5, 1999
Corporate OfficerCfo Jun 23, 2010
Courtney Cooper Individual Corporate DirectorBoard Member Jul 1, 2016 9.09%
Corporate DirectorBoard Member Jul 1, 2016
Mary Napier Individual Corporate DirectorBoard Member Jul 1, 2014 9.09%
Corporate DirectorBoard Member Jul 1, 2014
Brian Vance Individual Corporate DirectorBoard Member Jul 1, 2020
Debrina Williams Individual Corporate DirectorBoard Member Jul 1, 2023
Priscilla Byrnside Individual Corporate DirectorBoard Memeber Jul 1, 2020
Corporate DirectorBoard Member Jul 1, 2020
Christy Laxton Individual Corporate DirectorBoard Memeber Jul 1, 2023
Lori Huffman Individual Corporate DirectorBoard Member Jul 1, 2021
Karl Melkus Individual Corporate DirectorBoard Member Jul 1, 2023
Dana Snyder Individual Corporate DirectorBoard Member Jul 1, 2020
Audrey Robinette Individual Corporate DirectorBoard Member Jul 1, 2020

Practitioners & affiliated clinicians

Practitioners 63

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678233600000",
    "number": "1942274543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 LYNN AVE",
            "city": "HAMLIN",
            "state": "WV",
            "postal_code": "255231138",
            "telephone_number": "304-824-5806",
            "fax_number": "304-824-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 LYNN AVE",
            "city": "HAMLIN",
            "state": "WV",
            "postal_code": "255231138",
            "telephone_number": "304-824-5806",
            "fax_number": "304-824-5804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN COUNTY PRIMARY CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-13",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A",
        "authorized_official_last_name": "LEACH",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-824-5806"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0022695001",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILROAD",
            "identifier": "CA9760",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamlin, WV

Sources for this page

Verify at the official NPI Registry.