NPIMap

Organization Active NPI

Community Health Centers of Pinellas Inc.

  • Federally Qualified Health Center (FQHC)
  • St Petersburg, FL
National Provider Identifier
1013669878
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CENTERS OF PINELLAS INC.
Practice address
6450 38TH Ave N Ste 400
St Petersburg, FL 33710-1653
Phone
(727) 824-8181
Fax
(727) 824-8153
NPI assigned
Jan 24, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Authorized official

Name
Edward Kucher
Title
Chief Regulatory Officer
Phone
(727) 824-8100

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

6450 38TH Ave N Ste 400
St Petersburg, FL 33710-1653

Mailing address

14100 58TH St N Ste 100
Clearwater, FL 33760-9900
Phone (727) 824-8181

Other identifiers 1

IdentifierTypeStateIssuer
029565534MedicaidFL

Other names 2

  • Evara Health Doing business as
  • Evara Health - Tyrone Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040131000031 FL Part B Supplier - Clinic/Group Practice 8527961028 Receives reassigned benefits from 135 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Largo, FL; Tarpon Springs, FL; St Petersburg, FL; Saint Petersburg, FL; Pinellas Park, FL; Dunedin, FL; Clearwater, FL
O20220802002281 FL Part A Provider - Federally Qualified Health Center (FQHC) 8527961028 Practice locations: St Petersburg, FL

Federally qualified health center certification: CCN 691046

Legal name
COMMUNITY HEALTH CENTER OF PINELLAS INC
Doing business as
EVERA HEALTH AT CAMPBELL PARK
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 2, 2022
Last certification
Aug 2, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 14, 1980 in FL
Enrollment address
6450 38TH Avenue N
Suite 400 and Suite 410
St Petersburg, FL 33710-1653

Other NPIs with the same Medicare PAC ID 19

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

View all 19

Other NPIs on the same Medicare enrollment 18

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

View all 18

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
10D2328876Evara Health6450 38TH Street N Ste 400, Saint Petersburg, FL 33710Provider-performed microscopyAug 18, 2027

National Provider Directory

National Provider Directory

Locations

701 16th St S
Bldg 7
St Petersburg, FL 33705

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
Elodie Dorso Individual Corporate DirectorCeo Feb 2, 2018
W-2 Managing EmployeeCeo Feb 2, 2018
Operational/Managerial ControlCeo Feb 2, 2018
Edward Kucher Individual Corporate DirectorCro Mar 16, 2018
W-2 Managing Employee Mar 16, 2018

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1642982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759968000000",
    "number": "1013669878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14100 58TH ST N STE 100",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337609900",
            "telephone_number": "727-824-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6450 38TH AVE N STE 400",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337101653",
            "telephone_number": "727-824-8181",
            "fax_number": "727-824-8153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS OF PINELLAS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-24",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A",
        "authorized_official_last_name": "KUCHER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "CHIEF REGULATORY OFFICER",
        "authorized_official_telephone_number": "727-824-8100"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029565534",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evara Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Evara Health - Tyrone",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.