NPIMap

Organization Active NPI

Southeast, Inc.

  • Federally Qualified Health Center (FQHC)
  • Columbus, OH
National Provider Identifier
1982152799
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
H80CS22681-06-01 Issued in OH
Legal business name
SOUTHEAST, INC.
Practice address
924 E Main St
Columbus, OH 43205-2338
Phone
(614) 360-0251
NPI assigned
Sep 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

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

Authorized official

Name
Charles Tong
Title
Cfo
Phone
(614) 813-0177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X H80CS22681-06-01 OH Primary

Addresses

Primary practice location

924 E Main St
Columbus, OH 43205-2338

Mailing address

16 W Long St
Columbus, OH 43215-2815
Phone (614) 225-0990

Other identifiers 1

IdentifierTypeStateIssuer
0193469MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161025001228 OH Part A Provider - Federally Qualified Health Center (FQHC) 8426014853 Practice locations: Columbus, OH

Federally qualified health center certification: CCN 361119

Legal name
SOUTHEAST INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 14, 2016
Last certification
Oct 14, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 9, 1978 in OH
Enrollment address
924 E Main St
Columbus, OH 43205-2338

Other NPIs with the same Medicare PAC ID 15

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

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Southeast Inc Billing D22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Kori J Manus Individual Corporate DirectorBoard Member Jan 1, 2004
Thomas Burns Individual Corporate OfficerChairman Feb 1, 2013
Eileen M Goodman Individual Corporate DirectorBoard Member Jan 1, 2001
Tom Shanahan Individual Corporate OfficerBoard Member Jul 1, 2022
Thomas Patrick Halaiko Individual Corporate DirectorBoard Member Jul 1, 2014
Art Deleon Individual Corporate DirectorBoard Member Jun 1, 2022
Angela Fry Individual Corporate DirectorVice President Jul 1, 2018
Sarah Lenkay Individual Corporate DirectorBoard Member Jul 1, 2022
Dianne Fidelibus Individual Corporate DirectorBoard Member Jun 26, 2024
Steve Sielschott Individual Corporate DirectorSecretary Jan 1, 2019
William F Lee Individual Corporate OfficerCeo Sep 1, 2007
Charles Chiahsing Tong Individual Corporate OfficerCfo May 5, 2025
Operational/Managerial ControlCfo May 5, 2025
Kate Hamilton Individual Corporate OfficerMember at Large Jul 1, 2014
Wendy Williams Individual Corporate OfficerCoo May 5, 2025
Operational/Managerial ControlChief Operations Officer May 5, 2025

Practitioners & affiliated clinicians

Practitioners 48

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

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768521600000",
    "number": "1982152799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 W LONG ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432152815",
            "telephone_number": "614-225-0990",
            "fax_number": "614-225-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 E MAIN ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052338",
            "telephone_number": "614-360-0251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-21",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A",
        "authorized_official_last_name": "TONG",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "614-813-0177"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "OH",
            "license": "H80CS22681-06-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0193469",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.