NPIMap

Organization Active NPI

Lincoln County Primary Care Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Hamlin, WV
National Provider Identifier
1962583054
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
81 Lincoln Panther Way
Hamlin, WV 25523-1169
Phone
(304) 824-6090
Fax
(304) 824-6094
NPI assigned
Oct 17, 2006
Organization subpart
Yes
Parent organization
LINCOLN COUNTY PRIMARY CARE CENTER, INC.As reported in NPPES

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

81 Lincoln Panther Way
Hamlin, WV 25523-1169

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
CA9760OtherWVMEDICARE RR
3810011409MedicaidWV

Other names 1

  • LCHS Panther Center for Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060908000457 WV Part A Provider - Federally Qualified Health Center (FQHC) 6204821879 1 other NPI on this enrollment
Practice locations: Hamlin, WV
O20260312001218 WV Part B Supplier - Clinic/Group Practice 6204821879 Receives reassigned benefits from 4 practitioners
Practice locations: Hamlin, WV

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

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 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D2055312LCHS Panther Center for Health81 Lincoln Panther Way, Hamlin, WV 25523Certificate of waiverMar 7, 2027

National Provider Directory

National Provider Directory
Tax ID family
Man Rexcellence Program22 organizations share this tax ID, including this one
Part of
Man Rexcellence Program

Other organizations with this tax ID 21

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

View all 21

Locations

40 Shae Ave
Chapmanville, WV 25508
Phone (304) 855-2211

1 Pioneer Path
Man, WV 25635
Phone (304) 583-7295

Ownership & related parties

All disclosed owners & managing parties 12

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%
Jerry Lawson Individual Corporate DirectorBoard Member Jul 1, 2017 9.09%
Letitia Weaver-Scites Individual W-2 Managing EmployeeCredentialing Coordinator Apr 11, 2012
Lisa Leach Individual Corporate OfficerCeo Mar 31, 2018
David Boggess Individual Corporate DirectorDirector Jul 1, 2018
Ollie Hunting Individual Corporate DirectorBoard Member Jul 1, 2014 9.09%
Nancy Godby Individual Corporate DirectorBoard Member Jul 1, 2018
Kathryn Lambdin Individual Corporate DirectorBoard Member Jul 1, 2014 9.09%
Tab Mathis Individual Corporate DirectorBoard Member Aug 1, 2019
Julia a Barrett Individual W-2 Managing Employee May 5, 1999
Courtney Cooper Individual Corporate DirectorBoard Member Jul 1, 2016 9.09%
Mary Napier Individual Corporate DirectorBoard Member Jul 1, 2014 9.09%

Practitioners & affiliated clinicians

Practitioners 56

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678233600000",
    "number": "1962583054",
    "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": "81 LINCOLN PANTHER WAY",
            "city": "HAMLIN",
            "state": "WV",
            "postal_code": "255231169",
            "telephone_number": "304-824-6090",
            "fax_number": "304-824-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN COUNTY PRIMARY CARE CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LINCOLN COUNTY PRIMARY CARE CENTER, INC.",
        "enumeration_date": "2006-10-17",
        "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": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "CA9760",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810011409",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LCHS Panther Center for Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LCHS Panther Center for Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hamlin, WV

Sources for this page

Verify at the official NPI Registry.