Bread for the City Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

BREAD FOR THE CITY INC

Practice address

1700 Good Hope Road SE
Washington, DC 20020

Phone

(202) 386-7020

Fax

(202) 265-1970

NPI assigned

Aug 20, 2021

Last updated

Dec 28, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Randi Carol Abramson, MD

Title

Chief Medical Officer

Phone

(202) 265-2400

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013683762. Details of each certification follow.

• CCN 091877 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 091877

Legal name

BREAD FOR THE CITY,INC.

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jan 17, 2022

Last certification

Jan 17, 2022

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Mar 15, 1978 in DC

Enrollment address

1700 Good Hope Rd SE
Washington, DC 20020-4708

Other NPIs with the same Medicare PAC ID 1

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

• Bread for the City,Inc.

  • Federally Qualified Health Center (FQHC)
  • Washington, DC
  • NPI 1699950311

  7719042902

  Same PAC ID

Tax ID family

Bread for the City3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Bread for the City

  • Dental Clinic/Center
  • Washington, DC
  • NPI 1861778136
  NPD tax ID
• Bread for the City,Inc.

  • Specialist
  • Washington, DC
  • NPI 1447128921
  NPD tax ID

Locations

All disclosed owners & managing parties 21

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

Owners & managing parties with NPI records 2

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

• Randi Carol Abramson, MD

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1841379252

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Bread for the City,Inc.

  • Federally Qualified Health Center (FQHC)
  • Washington, DC
  • NPI 1699950311

  5% Or Greater Direct Ownership Interest

  CMS ownership

Practitioners 17

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.

• Summer Batterson, LGSW

  • Clinical Social Worker
  • Washington, DC
  • NPI 1750101077
  NPD
• Sabrina Patrice Butler, FNP-C

  • Family Nurse Practitioner
  • Washington, DC
  • NPI 1093342669
  NPD
• Irene Escalante Lopez, LGSW

  • Social Worker
  • Washington, DC
  • NPI 1710707757
  NPD
• Kristen Jones

  • Clinical Social Worker
  • Washington, DC
  • NPI 1386398527
  NPD
• Ashley Moore, LICSW

  • Clinical Social Worker
  • Washington, DC
  • NPI 1982199642
  NPD
• Shumuel Ofosu-Koranteng

  • Physician Assistant
  • Washington, DC
  • NPI 1376267609
  NPD
• Petrea Denise Simpson, LPC

  • Professional Counselor
  • Washington, DC
  • NPI 1144706722
  NPD
• Evan James Smith, DO

  • Family Medicine Physician
  • Washington, DC
  • NPI 1316682214
  NPD
• Brionne Williams

  • Primary Care Nurse Practitioner
  • Washington, DC
  • NPI 1659816098
  NPD
• Kristin Ashby

  • Family Nurse Practitioner
  • Anchorage, AK
  • NPI 1922468743
  NPD
• Natalie Gobrial, LGPC

  • Professional Counselor
  • Baltimore, MD
  • NPI 1316616725
  NPD
• Jessica Young Won Hahm, O.D.

  • Optometrist
  • Havre de Grace, MD
  • NPI 1841858065
  NPD

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640649600000",
    "number": "1013683762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 7TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200013201",
            "telephone_number": "202-265-2400",
            "fax_number": "202-265-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 GOOD HOPE ROAD SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20020",
            "telephone_number": "202-386-7020",
            "fax_number": "202-265-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAD FOR THE CITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-20",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A",
        "authorized_official_last_name": "ABRAMSON",
        "authorized_official_first_name": "RANDI",
        "authorized_official_middle_name": "CAROL",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "202-265-2400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila Bray-Smith
• Patricia Anne Bray, MD, MPH
• Rashanda Bray, LCSW
• Merisel Brazoban de Zapata
• Bread for the City
• Bread for the City,Inc.
• Bread for the City,Inc.
• Jennifer Breads, RN
• Breaking Cycles Therapeutic Services LLC
• Breaking Silos in Medicine LLC

• Federally Qualified Health Center (FQHC) in Washington, DC
• Providers in Washington, DC by specialty
• Federally Qualified Health Center (FQHC) in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.