LINCOLN COMMUNITY HEALTH CENTER, INCORPORATED (NPI# 1780631374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780631374 |
| Entity Type | Organization |
| Organization Name | LINCOLN COMMUNITY HEALTH CENTER, INCORPORATED |
| Other Organization Name | WALLTOWN CLINIC |
| Practice Address |
815 Broad St Durham NC 27705-4137 |
| Mailing Address |
Po Box 52119 Durham NC 27717-2119 |
| Practice Telephone | 9194161254 |
| Practice Fax Number | 9194161285 |
| Mailing Telephone | 9199564000 |
| Mailing Fax Number | 9199564535 |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2015-04-01 |
| 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, INCORPORATION |
| 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 | 344500A | 05 | |
| NC | NC BC/BS ID NUMBER | 03055 | 01 |
| NC | 344500C | 05 |
| Other Name | Type Code |
|---|---|
| WALLTOWN CLINIC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598709198 | Lincoln Community Health Center, Incorporated | Clinic/Center | 1313 Halley St, Durham, NC 27707-1227 | 2006-06-15 |
| 1942240544 | Lincoln Community Health Center, Incorporated | Clinic/Center | 412 Liberty St, Durham, NC 27701-3408 | 2006-06-08 |
| 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 |
815 BROAD ST |
| City | DURHAM |
| State | NC |
| Zip Code | 27705-4137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003929803 | Kimberly Hawblitzel Yarnall | Family Medicine | 815 Broad St, Durham, NC 27705-4137 | 2006-08-16 |
| 1548205016 | Kaitlyn Alger Granda | Physician Assistant | 815 Broad St, Durham, NC 27705-4137 | 2006-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371755 | Tyler Beach, Lcsw, Pllc | Social Worker | 2740 Spencer Street, Durham, NC 27705 | 2019-11-20 |
| 1720635477 | Brittany W Fry | Registered Nurse | 2301 Erwin Road, Hafs Building, Room 6670, Durham, NC 27705 | 2019-08-19 |
| 1760968044 | Nicole D Moore | Social Worker | 1921 N. Pointe Dr, Suite 280, Durham, NC 27705 | 2018-07-19 |
| 1144757097 | Emileigh S Dowling | Physical Therapist | 3475 Erwin Rd Bldg 2, Durham, NC 27705 | 2017-05-22 |
| 1487195350 | Daniel Lynch | Physical Therapist | 3475 Erwin Road, Pepsico Building, Durham, NC 27705 | 2017-03-13 |
| 1780131839 | Michael A Fitzpatrick Iv | Physical Therapist | 3475 Erwin Rd Bldg 2nd, Durham, NC 27705 | 2016-09-07 |
| 1609241736 | Julia Power Constant | Physician Assistant | Dumc Box 3913, Durham, NC 27705 | 2015-12-01 |
| 1518344159 | Amanda Clark Coniglio | Internal Medicine | 2301 Erwin Rd # 3845, Durham, NC 27705 | 2015-05-04 |
| 1720486988 | Jennifer Dawn Pace | Physician Assistant | 1821 Hillandale Road Suite 24a, Duke Urgent Care, Durham, NC 27705 | 2014-12-19 |
| 1942612106 | Rachel Hibberd | Psychologist | 508 Fulton Avenue, Durham Va Medical Center, Durham, NC 27705 | 2014-05-22 |
| Find all providers in zip 27705 | ||||
| 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 |
| 1598709198 | Lincoln Community Health Center, Incorporated | Clinic/Center | 1313 Halley St, Durham, NC 27707-1227 | 2006-06-15 |
| 1942240544 | Lincoln Community Health Center, Incorporated | Clinic/Center | 412 Liberty St, Durham, NC 27701-3408 | 2006-06-08 |
| 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.