NPIMap

Organization Active NPI

Project Health Inc

Doing business as Langley Health Services

  • Federally Qualified Health Center (FQHC)
  • Inverness, FL
National Provider Identifier
1972959302
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PROJECT HEALTH INC
Doing business as
Langley Health Services
Practice address
314 S Line Ave
Inverness, FL 34452-4606
Phone
(352) 419-5760
Fax
(352) 419-7085
NPI assigned
May 4, 2016
Last updated
Dec 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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

Authorized official

Name
Thomas Chase
Title
Ceo
Phone
(352) 793-5900

Specialties & licenses 1

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

Addresses

Primary practice location

314 S Line Ave
Inverness, FL 34452-4606

Mailing address

1425 S US 301
Sumterville, FL 33585-5141
Phone (352) 793-5900

Other identifiers 2

IdentifierTypeStateIssuer
029547724MedicaidFL
681110OtherFLMEDICARE FIRST COAST PART A

Other names 1

  • Langley Health Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040601001397 FL Part B Supplier - Clinic/Group Practice 0446153399 Receives reassigned benefits from 69 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sumterville, FL; Ocala, FL; Lecanto, FL; Inverness, FL; Crystal River, FL; Homosassa, FL
O20171013002866 FL Part A Provider - Federally Qualified Health Center (FQHC) 0446153399 Practice locations: Inverness, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972959302. Details of each certification follow.

Federally qualified health center certification: CCN 681110

Legal name
PROJECT HEALTH INC
Doing business as
LANGLEY HEALTH SERVICES
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 16, 2017
Last certification
Oct 16, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationProprietary
Incorporated
Feb 4, 1977 in FL
Enrollment address
314 S Line Ave
Inverness, FL 34452-4606

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 10

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
10D2021274Project Health Inc Dba Langley Health Services314 S Line Ave, Inverness, FL 34452Certificate of waiverMar 9, 2027

National Provider Directory

National Provider Directory
Tax ID family
Thomas E Langley Med CT12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

7205 SE Maricamp Rd
Ocala, FL 34472
Phone (352) 680-0324

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Jon Simpson Individual Corporate Director Oct 23, 2008
Vicki Wynns Individual Corporate OfficerCoo Feb 6, 2012
Wanda Francis Individual Corporate Director Dec 15, 2016
Ivory Gray Individual Corporate Director Jan 23, 2003
Deana Lindsay Individual Corporate Director Nov 15, 2012
James Bodenner Individual Corporate Director Aug 23, 2018
Paula Knight Individual Corporate Director Jun 23, 2011
Thomas G Chase Individual Corporate OfficerCeo Apr 22, 2013
John Sivon Individual W-2 Managing EmployeeChief Strategy Officer Jan 5, 2015
Mary Lighty Individual Corporate OfficerAuthorized Official Nov 10, 2020
W-2 Managing EmployeeAuthorized Official Nov 10, 2020
Operational/Managerial ControlAuthorized Official Nov 10, 2020
Kristy Lindke Individual Corporate Director Aug 24, 2017
Jimmie Enderle Individual Corporate Director Mar 25, 2004
Maria B Bello Individual Corporate DirectorDirector Feb 22, 2018
June E Tickle Individual Corporate Director Aug 23, 2018
Sherry Olszanski Individual Corporate Director Nov 15, 2012
Brooke Morris Individual Corporate Director Sep 27, 2018

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Langley Health ServicesInverness, FL, CCN 681140 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 12, 1974
Project Health IncHomosassa, FL, CCN 101907 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 12, 1974

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Project Health Inc

    dba Langley Health Services

    • Federally Qualified Health Center (FQHC)
    • Inverness, FL
    • NPI 1427545375

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Project Health Inc

    dba Langley Health Services - Homosassa

    • Federally Qualified Health Center (FQHC)
    • Homosassa, FL
    • NPI 1972767481

    5% Or Greater Direct Ownership Interest

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 6

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": "1462320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607904000000",
    "number": "1972959302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 S US 301",
            "city": "SUMTERVILLE",
            "state": "FL",
            "postal_code": "335855141",
            "telephone_number": "352-793-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 S LINE AVE",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344524606",
            "telephone_number": "352-419-5760",
            "fax_number": "352-419-7085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROJECT HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-04",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A",
        "authorized_official_last_name": "CHASE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "352-793-5900"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029547724",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE FIRST COAST PART A",
            "identifier": "681110",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Langley Health Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Langley Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Inverness, FL

Sources for this page

Verify at the official NPI Registry.