FAIRFIELD COMMINITY HEALTH CENTER (NPI# 1609165307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609165307 |
| Entity Type | Organization |
| Organization Name | FAIRFIELD COMMINITY HEALTH CENTER |
| Practice Address |
123 E Main St Amanda OH 43102-0307 |
| Mailing Address |
1155 E Main St Lancaster Lancaster OH 43130-4056 |
| Practice Telephone | 7409694828 |
| Practice Fax Number | 7409694891 |
| Mailing Telephone | 7406896758 |
| Mailing Fax Number | 7406896759 |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2019-03-29 |
| Authorized Official Name | LISA EVANGELISTA (CEO) |
| Authorized Official Telephone | 7402776043 |
| Is Organization Subpart | Y |
| Parent Organization Name | FAIRFIELD COMMUNITY HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154714400 | Fairfield Comminity Health Center | Clinic/Center | 1155 E Main St, Lancaster, OH 43130-4056 | 2015-03-11 |
| 1689079782 | Fairfield Comminity Health Center | Clinic/Center | 1500 E Main St, Lancaster, OH 43130-3478 | 2014-10-31 |
| 1396024212 | Fairfield Comminity Health Center | Clinic/Center | 1055 W Market St, Suite H, Baltimore, OH 43105-1283 | 2011-08-09 |
| 1104129055 | Fairfield Comminity Health Center | Public Health or Welfare | 216 Trace Dr, Lancaster, OH 43130-4151 | 2010-12-15 |
| Street Address |
123 E MAIN ST |
| City | AMANDA |
| State | OH |
| Zip Code | 43102-0307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447699129 | Christina J Olive | Nurse Practitioner | 123 E Main St, Amanda, OH 43102-1111 | 2013-06-17 |
| 1891982641 | Heather Schultz | Nurse Practitioner | 123 E Main St, Amanda, OH 43102-1111 | 2007-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629000500 | Tammy Arlene Thomas | Licensed Practical Nurse | 10375 St. Rt. 22, Amanda, OH 43102 | 2006-07-07 |
| 1902105927 | Samantha Jayne Sheets | Registered Nurse | 111 S Johns St, Amanda, OH 43102-0342 | 2011-03-16 |
| 1962801365 | Lynn Patterson | Speech-Language Pathologist | 328 E Main St, Amanda, OH 43102-9330 | 2014-08-21 |
| 1740435742 | Amanda-clearcreek Local School District | Local Education Agency (LEA) | 328 E Main St, Amanda, OH 43102-9330 | 2008-11-19 |
| 1114561297 | Brandie Anne Herdlitzka | Family Medicine | 5115 Amanda Northern Rd Sw, Amanda, OH 43102-9332 | 2019-11-01 |
| 1609159243 | Shelly B Russ | Licensed Practical Nurse | 6495 Julian Rd Sw, Amanda, OH 43102-9527 | 2011-09-20 |
| 1821387481 | Holly Spaulding | Custodial Care Facility | 395 Cedar Hill Rd Nw, Amanda, OH 43102-9586 | 2011-04-05 |
| 1164595062 | Amanda Township Trustees | Ambulance | 211 North Johns Street, Amanda, OH 43102-9702 | 2006-11-16 |
| 1003815689 | Jason L Rich | Family Medicine | 101 1/2 W. Main St., Amanda, OH 43102-9711 | 2005-07-18 |
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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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.