NPIMap

Organization Active NPI

Community Health Connection, Inc.

  • Federally Qualified Health Center (FQHC)
  • Tulsa, OK
National Provider Identifier
1013569961
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CONNECTION, INC.
Practice address
13702 E 46TH PL
Tulsa, OK 74134-5919
Phone
(918) 622-0641
Fax
(918) 622-4814
NPI assigned
Jul 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Authorized official

Name
Stephanie Zahner
Title
HR Manager
Phone
(918) 622-0641

Specialties & licenses 1

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

Addresses

Primary practice location

13702 E 46TH PL
Tulsa, OK 74134-5919

Mailing address

2321 E 3Rd St
Tulsa, OK 74104-1831
Phone (918) 710-4403

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190923001159 OK Part A Provider - Federally Qualified Health Center (FQHC) 5991756397 Practice locations: Tulsa, OK

Federally qualified health center certification: CCN 371944

Legal name
COMMUNITY HEALTH CONNECTION, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 20, 2019
Last certification
Sep 20, 2019
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Enrollment address
13702 E 46TH PL S
Tulsa, OK 74134-5919

Other NPIs with the same Medicare PAC ID 3

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2169546Community Health Connection, Inc13702 East 46TH Place, Tulsa, OK 74134Certificate of waiverJul 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
Comm HLTH Connection Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Kate Neary-Pounds Individual Contracted Managing Employee Feb 19, 2024
Corporate OfficerCeo Feb 19, 2024
Mary Miller Individual Corporate DirectorCfo May 15, 2017

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
K-W Clinical Construction ProjectTulsa, OK, CCN 371873 Federally qualified health center Operational/Managerial Control Nov 18, 2011

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562803200000",
    "number": "1013569961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2321 E 3RD ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741041831",
            "telephone_number": "918-710-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13702 E 46TH PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741345919",
            "telephone_number": "918-622-0641",
            "fax_number": "918-622-4814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CONNECTION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-11",
        "last_updated": "2019-07-11",
        "status": "A",
        "authorized_official_last_name": "ZAHNER",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "HR MANAGER",
        "authorized_official_telephone_number": "918-622-0641"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.