DBA Shawnee Family Health Center – Federally Qualified Health Center (FQHC), NPI 1063982924

DBA Shawnee Family Health Center is a healthcare provider. based in West union, Ohio. specializing in Federally Qualified Health Center (FQHC). The NPI Number for DBA Shawnee Family Health Center is 1063982924

Main info

Organization
Name
DBA Shawnee Family Health Center
NPI
1063982924
Phone
(937) 544-5400
Address
192 Chestnut Ridge Rd
Authorized Official
CYNTHIA HOLSTEIN CEO
Enumeration Date
4 December 2018
Last Update Date
9 May 2022

Contacts

REST API
shawnee.mental.health.center@clinisync.medicity.net
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience29
Completeness90
Years active:7State licenses:0Updated within 12 months

Provider Addresses for DBA Shawnee Family Health Center

  • 192 Chestnut Ridge Rd

    West Union, OH 456939584

    Phone: (937) 544-5400

    Type: Location

  • 225 Carlton Davidson Ln

    Coal Grove, OH 456382924

    Phone: (740) 533-0648

    Type: Location

  • 901, Washington Street, Sixth Street Historic District, Portsmouth, Scioto County, Ohio, 45662, United States

    PORTSMOUTH, OH 456623944

    Phone: (740) 355-8686

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-02-14

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-10-31 (592 days ago).

Enrollment records

1

Earliest due date

2024-10-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20190214000662OFederally Qualified Health Center (Fqhc)OH2024-10-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 45693)

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Reviews

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Frequently asked questions

What NPI should I save for DBA Shawnee Family Health Center?
Save NPI 1063982924 if you need a stable reference for DBA Shawnee Family Health Center.
Does this profile mean DBA Shawnee Family Health Center is currently active?
Yes — DBA Shawnee Family Health Center appears active in the national provider directory.
What kind of provider is DBA Shawnee Family Health Center?
The page reflects Federally Qualified Health Center (FQHC) for DBA Shawnee Family Health Center. Clinical services aligned with this taxonomy classification.
Where does public data place DBA Shawnee Family Health Center?
The snapshot lists West Union, Ohio for DBA Shawnee Family Health Center; download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Organization.

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