Ohio North East Health Systems Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Alliance, OH
NPI 1962491738 · NPPES record last updated Mar 17, 2018
Key facts
- NPI
- 1962491738
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 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
- Organization subpart
- No
Authorized official
- Name
- Mr. Ronald Dwinnells, MD
- Title
- Ceo
- Phone
- (330) 747-9551
Owners & managing parties with NPI records 1
-
Ronald Dwinnells, MD
Other NPIs with the same Medicare PAC ID 8
Corporate family (same tax ID) 22
Practitioners 35
-
Aron Blecher, M.D.
-
Elizabeth J Camera, LPCC
-
Rose Alexandria Cox, PA-C
-
Andrew Paul Eschman, PA-C
-
Bryan Jeffrey Eshelman, LPCC
-
Steven Joseph Humansky, PA-C
-
John Michael Jerome, CNP
-
Maria D Kowal, M.D.
-
Lori Ann Lander, PA-C
-
Aimee Lynn Lynch, RD LD
-
Michael Joseph Maggio Jr., MSN, PMHNP-BC
-
Madisyn Mackenzy Maloney, PA-C
-
Amanda Sue McCormick, CNP
-
Grace McCracken, PA-C
-
Catherine Migliozzi, FNP-C
-
Kelli A Motherwell, AGPCNP-C
-
Amity Lynn Patrone, MSN, APRN, PMHNP-BC
-
Joseph Petrolla, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
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
- Corporation · Non-profit
- Incorporated
- Feb 23, 1989 in OH
- Enrollment address
- 1390 S Arch Ave
Alliance, OH 44601-4111
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| William Thornton |
Corporate Director |
Apr 27, 2021 | |
| Dan Rupp |
Corporate Director |
Jul 30, 2018 | |
| Dennis Kuhns |
Corporate Director |
Jul 30, 2018 | |
| Judy Eiland |
Corporate Director |
Oct 24, 2017 | |
| Susan Montalbano |
W-2 Managing Employee |
Aug 4, 2014 | |
| Ronald Dwinnells |
Corporate Officer |
Jul 19, 1994 | |
| Tanya Murphy |
Corporate Director |
Nov 29, 2016 | |
| Damon Dohar |
Corporate Director |
Aug 29, 2017 | |
| Victor Wan-Tatah |
Corporate Director |
Nov 1, 2002 | |
| Tammy Parteleno |
Corporate Director |
Jul 25, 2017 | |
| Patricia Rupp |
Corporate Director |
Jul 30, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110505000243 | OH | Part a Provider - Federally Qualified Health Center (FQHC) | 1951395086 | Practice locations: Alliance, OH |
National Provider Directory
- Tax ID family
- Ohio North East Health Systems Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | |||
| Clinical Social Worker |
1041C0700X | |||
| Family Medicine Physician |
207Q00000X | |||
| Internal Medicine Physician |
207R00000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2476799 | Medicaid | OH |
Other names
- Good Samaritan Community Health Center
Other providers in Alliance, OH
- Kristy Nutter
- Margaret O'Gorman
- Landen Keith Ogle
- Ohio Eye Alliance, Inc.
- Ohio Foot and Ankle Center, LLC
- Ohio North East Health Systems, Inc.
- Ohio Podiatric Physicians and Surgeons Group, LLC
- Erica Ohler
- Olive Care Residential Inc
- Jordan Oliverio
All providers in Alliance, 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 Mar 17, 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.