NPIMap

Organization Active NPI

Ohio North East Health Systems Inc

  • Federally Qualified Health Center (FQHC)
  • Alliance, OH
National Provider Identifier
1962491738
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
OHIO NORTH EAST HEALTH SYSTEMS INC
Practice address
1390 S Arch Ave
Alliance, OH 44601-4111
Phone
(330) 821-3961
Fax
(330) 884-6120
NPI assigned
Oct 14, 2005
Last updated
Mar 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Mr. Ronald Dwinnells, MDNPI 1902893142
Title
Ceo
Phone
(330) 747-9551

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1390 S Arch Ave
Alliance, OH 44601-4111

Mailing address

726 Wick Ave
Youngstown, OH 44505-2827
Phone (330) 747-9551

Other practice location 1

405 S Linden Ave
Alliance, OH 44601-3088
Phone (330) 821-3961

Other names 1

  • Good Samaritan Community Health Center Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110505000243 OH Part A Provider - Federally Qualified Health Center (FQHC) 1951395086 Practice locations: Alliance, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962491738. Details of each certification follow.

Federally qualified health center certification: CCN 361888

Legal name
OHIO NORTH EAST HEALTH SYSTEMS INC
Doing business as
GOOD SAMARITAN COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 20, 2004
Last certification
Apr 20, 2004
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 23, 1989 in OH
Enrollment address
1390 S Arch Ave
Alliance, OH 44601-4111

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Ohio North East Health Systems Inc23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
William Thornton Individual Corporate DirectorDirector Apr 27, 2021
Dan Rupp Individual Corporate DirectorBoard Member Jul 30, 2018
Dennis Kuhns Individual Corporate DirectorBoard Chairman Jul 30, 2018
Judy Eiland Individual Corporate DirectorBoard Member Oct 24, 2017
Susan Montalbano Individual W-2 Managing EmployeeHuman Resources Employee Relations Aug 4, 2014
Ronald Dwinnells Individual Corporate OfficerChief Executive Officer Jul 19, 1994
Tanya Murphy Individual Corporate DirectorBoard Member Nov 29, 2016
Damon Dohar Individual Corporate DirectorBoard Member Aug 29, 2017
Victor Wan-Tatah Individual Corporate DirectorBoard Member Nov 1, 2002
Tammy Parteleno Individual Corporate DirectorBoard Member Jul 25, 2017
Patricia Rupp Individual Corporate DirectorBoard Member Jul 30, 2018

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1962491738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 WICK AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445052827",
            "telephone_number": "330-747-9551",
            "fax_number": "330-884-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 S ARCH AVE",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446014111",
            "telephone_number": "330-821-3961",
            "fax_number": "330-884-6120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 S Linden Ave",
            "address_purpose": "LOCATION",
            "city": "Alliance",
            "state": "OH",
            "postal_code": "446013088",
            "country_code": "US",
            "telephone_number": "330-821-3961",
            "fax_number": "330-821-0232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OHIO NORTH EAST HEALTH SYSTEMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-14",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "DWINNELLS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "330-747-9551",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Samaritan Community Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Alliance, OH

Sources for this page

Verify at the official NPI Registry.