NPIMap

Organization Active NPI

Community Health Alliance

  • Federally Qualified Health Center (FQHC)
  • Reno, NV
National Provider Identifier
1013143312
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH ALLIANCE
Practice address
3915 Neil Rd
Reno, NV 89502-6808
Phone
(775) 870-4333
Fax
(775) 870-4633
NPI assigned
Jun 2, 2009
Last updated
Jan 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Authorized official

Name
Jennifer Wheeler
Title
Cco
Phone
(775) 329-6300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

3915 Neil Rd
Reno, NV 89502-6808

Mailing address

680 S Rock Blvd
Reno, NV 89502-4113
Phone (775) 336-3003

Other names 1

  • Neil Road Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040701000827 NV Part B Supplier - Clinic/Group Practice 3577540160 Receives reassigned benefits from 68 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Reno, NV; Sun Valley, NV; Sparks, NV
O20130912000375 NV Part A Provider - Federally Qualified Health Center (FQHC) 3577540160 Practice locations: Reno, NV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013143312. Details of each certification follow.

Federally qualified health center certification: CCN 291843

Legal name
COMMUNITY HEALTH ALLIANCE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 5, 2013
Last certification
Nov 5, 2013
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 31, 1992 in NV
Enrollment address
3915 S Neil Road
Reno, NV 89502-6808

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Daniel R Spogen Individual Corporate DirectorBoard Member - at Large Member Aug 1, 2016
Bayo K Curry-Winchell Individual Corporate DirectorBoard Member Jan 1, 2022
Matthew Thorton Individual Corporate DirectorBoard Member - Vice-President Mar 1, 2020
Mathew Work Individual Corporate DirectorBoard Member Jan 1, 2022
Nathan Dupree Individual Other Sep 1, 2023
Sam King Individual Corporate OfficerCfo May 1, 2024
Oscar Dario Delgado Individual Corporate OfficerCeo Oct 7, 2019
W-2 Managing EmployeeCeo Oct 7, 2019
Casey Gillham Individual Corporate OfficerCao Jun 22, 2020
Noemi Gomez Individual Other Dec 1, 2022
Victor Salcido Individual Corporate OfficerClo Oct 11, 2021
Paul R Parent Individual Corporate DirectorBoard Member Feb 1, 2011
Jennifer Wheeler Individual Corporate OfficerCco Jan 24, 2022
Frank Perez Individual Corporate DirectorBoard Member Aug 1, 2018
Laura Martinez Individual Corporate DirectorBoard Member - Treasurer Sep 1, 2020
Alexsis Adams Individual Corporate DirectorBoard Member - Secretary Apr 1, 2021
Liliana Lopez-Estrada Individual Corporate DirectorBoard Member Oct 1, 2018

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1013143312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 S ROCK BLVD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895024113",
            "telephone_number": "775-336-3003",
            "fax_number": "775-336-0653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 NEIL RD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895026808",
            "telephone_number": "775-870-4333",
            "fax_number": "775-870-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-02",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CCO",
        "authorized_official_telephone_number": "775-329-6300"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neil Road",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Neil Road",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.