LINCOLN COMMUNITY HEALTH CENTER, INCORPORATED (NPI# 1598709198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598709198 |
| Entity Type | Organization |
| Organization Name | LINCOLN COMMUNITY HEALTH CENTER, INCORPORATED |
| Other Organization Name | LYON PARK CLINIC |
| Practice Address |
1313 Halley St Durham NC 27707-1227 |
| Mailing Address |
Po Box 52119 Durham NC 27717-2119 |
| Practice Telephone | 9195364205 |
| Practice Fax Number | 9195361221 |
| Mailing Telephone | 9199564000 |
| Mailing Fax Number | 9196672322 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2015-03-19 |
| Authorized Official Name | PHILIP A HAREWOOD (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9199564022 |
| Authorized Official Credential | MBA |
| Is Organization Subpart | Y |
| Parent Organization Name | LINCOLN COMMUNITY HEALTH CENTER,INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | NC BC/BS PROV NO | 03055 | 01 |
| NC | 344500A | 05 | |
| NC | 344500C | 05 |
| Other Name | Type Code |
|---|---|
| LYON PARK CLINIC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942240544 | Lincoln Community Health Center, Incorporated | Clinic/Center | 412 Liberty St, Durham, NC 27701-3408 | 2006-06-08 |
| 1780631374 | Lincoln Community Health Center, Incorporated | Clinic/Center | 815 Broad St, Durham, NC 27705-4137 | 2006-05-28 |
| 1649210279 | Lincoln Community Health Center, Incorporated | Clinic/Center | 3727 Fayetteville St, Durham, NC 27707-4718 | 2006-06-08 |
| 1891742557 | Lincoln Community Health Center, Incorporated | Clinic/Center | 414 E Main St, Durham, NC 27701-3720 | 2006-05-28 |
| 1114978582 | Lincoln Community Health Center, Incorporated | Clinic/Center | 1301 Fayetteville St, Durham, NC 27707-2325 | 2006-05-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LINCOLN COMMUNITY HEALTH CENTER, INCORPORATED | 1301 Fayetteville St, Durham, NC 27707-2325 |
| Street Address |
1313 HALLEY ST |
| City | DURHAM |
| State | NC |
| Zip Code | 27707-1227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154352961 | Diane Marie Davis | Physician Assistant | 1313 Halley St, Lyon Park Clinic, Durham, NC 27707-1227 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538785928 | Ceara Smith | Social Worker | 1415 W Nc 54 Buidling 200, Suite 111, Durham, NC 27707 | 2020-06-22 |
| 1114554094 | Lauren Michelle Grosse | Physician Assistant | Fastmed Urgent Care 7010 Nc-751, Durham, NC 27707 | 2020-03-23 |
| 1386289635 | Ashley Bailey | Counselor | 1801 Fayetteville Street, Durham, NC 27707 | 2019-11-11 |
| 1881249886 | Erin Ramona Leger | Physical Therapist | 3706 Mayfair St, Ste 120, Durham, NC 27707 | 2019-08-06 |
| 1417417262 | Carmen Elisabeth Sanchez | Psychologist | 3326 Durham Chapel Hill Blvd Bldg D, Durham, NC 27707 | 2019-03-20 |
| 1477026144 | Pope Behavioral Health and Wellness | Counselor | 5102 Chapel Hill Durham Blvd., Suite 101, Durham, NC 27707 | 2019-01-06 |
| 1043780778 | Jessica Ann Revels | Counselor | 1415 West North Carolina 54, Building 100 Suite # 204, Durham, NC 27707 | 2018-11-26 |
| 1558830125 | Michael Brown | Counselor | 1502 W Nc-54, Suite 505, Durham, NC 27707 | 2018-11-13 |
| 1780152827 | Cassandra Gerwig Shaw | Registered Nurse | 5324 Mcfarland Dr Ste 310, Durham, NC 27707 | 2018-11-07 |
| 1942776232 | Lisa J Keskitalo | Physical Therapist | 3708 Mayfair St Ste 120, Durham, NC 27707 | 2018-10-15 |
| Find all providers in zip 27707 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801295936 | Lincoln Community Health Center, Inc. | Clinic/Center | 3901 N Roxboro St Ste 101, Durham, NC 27704-2181 | 2014-08-14 |
| 1376770537 | Lincoln Community Health Center, Inc. | Clinic/Center | 401 N Driver St, Durham, NC 27703-3007 | 2009-06-16 |
| 1942240544 | Lincoln Community Health Center, Incorporated | Clinic/Center | 412 Liberty St, Durham, NC 27701-3408 | 2006-06-08 |
| 1780631374 | Lincoln Community Health Center, Incorporated | Clinic/Center | 815 Broad St, Durham, NC 27705-4137 | 2006-05-28 |
| 1013202373 | Lincoln Community Health Center, Inc. | Clinic/Center | 309 Crutchfield St, Durham, NC 27704-2754 | 2011-06-15 |
| 1649210279 | Lincoln Community Health Center, Incorporated | Clinic/Center | 3727 Fayetteville St, Durham, NC 27707-4718 | 2006-06-08 |
| 1891742557 | Lincoln Community Health Center, Incorporated | Clinic/Center | 414 E Main St, Durham, NC 27701-3720 | 2006-05-28 |
| 1114978582 | Lincoln Community Health Center, Incorporated | Clinic/Center | 1301 Fayetteville St, Durham, NC 27707-2325 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831799667 | Bakersville Community Medical Clinic, Inc | Clinic/Center | 71 Blue Ridge Ln, Burnsville, NC 28714-7270 | 2020-10-30 |
| 1245842178 | Gaston Family Health Services, Inc. | Clinic/Center | 144 William Ellis Dr, Advance, NC 27006-7990 | 2020-08-21 |
| 1851909444 | Gaston Family Health Services, Inc. | Clinic/Center | 302 28th Ave Ne, Hickory, NC 28601-1116 | 2020-07-20 |
| 1750999496 | Gaston Family Health Services, Inc. | Clinic/Center | 180 War Eagle Dr, Mocksville, NC 27028-6151 | 2020-07-20 |
| 1518575265 | Gaston Family Health Services, Inc. | Clinic/Center | 4675 Oxford School Rd, Claremont, NC 28610-9468 | 2020-07-20 |
| 1124636873 | Gaston Family Health Services, Inc. | Clinic/Center | 451 Catawba Valley Blvd, Hickory, NC 28602-9631 | 2020-07-20 |
| 1093323099 | Gaston Family Health Services, Inc. | Clinic/Center | 5040 E Bandys Xrd, Catawba, NC 28609-8075 | 2020-07-16 |
| 1366088957 | Gaston Family Health Services, Inc. | Clinic/Center | 497 Farmington Rd, Mocksville, NC 27028-7639 | 2019-11-19 |
| 1285270868 | Gaston Family Health Services, Inc. | Clinic/Center | 160 Martin Luther King Junior Rd, Mocksville, NC 27028 | 2019-11-19 |
| 1306481957 | Gaston Family Health Services, Inc. | Clinic/Center | 3407 Plateau Rd, Newton, NC 28658-8809 | 2019-11-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.