NPIMap

Organization Active NPI

Choptank Community Health System Inc

Doing business as Easton Health Center

  • Federally Qualified Health Center (FQHC)
  • Easton, MD
National Provider Identifier
1013464668
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CHOPTANK COMMUNITY HEALTH SYSTEM INC
Doing business as
Easton Health Center
Practice address
522 Cynwood Dr Ste 100
Easton, MD 21601-3877
Phone
(410) 770-8910
Fax
(833) 908-2284
NPI assigned
Sep 1, 2016
Last updated
Jan 26, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CHOPTANK COMMUNITY HEALTH SYSTEM INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Authorized official

Name
Sara Rich
Title
Ceo
Phone
(410) 479-4306

Specialties & licenses 1

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

Addresses

Primary practice location

522 Cynwood Dr Ste 100
Easton, MD 21601-3877

Mailing address

522 Cynwood Dr Ste 100
Easton, MD 21601-3877
Phone (410) 770-8910

Other names 1

  • Easton Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161107002005 MD Part A Provider - Federally Qualified Health Center (FQHC) 0648189274 Practice locations: Easton, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013464668. Details of each certification follow.

Federally qualified health center certification: CCN 211909

Legal name
CHOPTANK COMMUNITY HEALTH SYSTEM INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 21, 2016
Last certification
Oct 21, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 20, 1978 in MD
Enrollment address
522 Cynwood Dr
Ste 100
Easton, MD 21601-3877

Other NPIs with the same Medicare PAC ID 11

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

National Provider Directory

National Provider Directory
Tax ID family
Choptank Community Heal103 organizations share this tax ID, including this one
Part of
Choptank Community Heal

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20853/brand/1/csg/1/fhir/r4

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Benjamin Cottle Individual Corporate OfficerCfo Jul 16, 2018
Jennifer W Yost Individual Corporate DirectorBoard Member Feb 1, 2015
Sara K Rich Individual Corporate OfficerCeo Jan 1, 2017
Rebecca Loukides Individual Corporate DirectorBoard Member Aug 1, 2016
Anna Sierra Individual Corporate DirectorBoard Member Feb 28, 2020
Savannah S Winston Individual Corporate DirectorBoard Member Feb 28, 2020
Sandra O'Neill Individual Corporate DirectorBoard Member May 23, 2019
Wayne Cole Individual Corporate DirectorBoard Member Jan 31, 2020
Matthew R Peters Individual Corporate DirectorBoard Member Apr 1, 2015
Lorenzo L Hughes Individual Corporate DirectorBoard Member Mar 25, 2019
Kimberly R Love Individual W-2 Managing EmployeeFinance Director Feb 19, 2002
Austin N Webster Individual Corporate DirectorBoard Member Jan 1, 2009
Sara B Visintainer Individual Corporate DirectorBoard Member Feb 1, 2015

Owners & managing parties with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674691200000",
    "number": "1013464668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 CYNWOOD DR STE 100",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216013877",
            "telephone_number": "410-770-8910",
            "fax_number": "833-908-2284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 CYNWOOD DR STE 100",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216013877",
            "telephone_number": "410-770-8910",
            "fax_number": "833-908-2284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOPTANK COMMUNITY HEALTH SYSTEM INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHOPTANK COMMUNITY HEALTH SYSTEM INC",
        "enumeration_date": "2016-09-01",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A",
        "authorized_official_last_name": "RICH",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-479-4306"
    },
    "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": "Easton Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Easton, MD

Sources for this page

Verify at the official NPI Registry.