Active NPI
Charles Drew Health Center, Inc.
- Federally Qualified Health Center (FQHC)
- Omaha, NE
National Provider Identifier
1023673282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- CHARLES DREW HEALTH CENTER, INC.
- Practice address
- 2120 N 30TH St Ste 100
Omaha, NE 68111-3701 - Phone
- (402) 455-2229
- Fax
- (402) 939-0114
- NPI assigned
- May 3, 2019
- Organization subpart
- Yes
- Parent organization
- CHARLES DREW HEALTH CENTER INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Andre Stringfellow
- Title
- Cheif Financial Officer
- Phone
- (402) 457-1215
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Primary |
Addresses
Primary practice location
2120 N 30TH St Ste 100
Omaha, NE 68111-3701
Mailing address
2915 Grant St
Omaha, NE 68111-3863
Phone (402) 451-3553
Other practice location 1
2915 Grant St
Omaha, NE 68111-3863
Phone (402) 451-3553
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10026276410 | Medicaid | NE | |
| 10026276411 | Other | NE | MEDICAID-NON FQHC |
Other names 1
- Charles Drew Health Center, Inc. at Highlander Accelerator
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Federally qualified health center certification: CCN 281850
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- CHARLES DREW HEALTH CENTER INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- May 24, 2019
- Last certification
- May 24, 2019
- Ownership / control type
- For profit – corporation
- Facility address
- 2120 N 30TH St Ste, 100
Omaha, NE 68111
National Provider Directory
National Provider Directory- Part of
- Benson Community Health Center
Locations
2915 Grant St
Omaha, NE 68111
Phone (402) 451-3553
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556841600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1720656000000",
"number": "1023673282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2915 GRANT ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681113863",
"telephone_number": "402-451-3553",
"fax_number": "402-457-1220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2120 N 30TH ST STE 100",
"city": "OMAHA",
"state": "NE",
"postal_code": "681113701",
"telephone_number": "402-455-2229",
"fax_number": "402-939-0114"
}
],
"practiceLocations": [
{
"address_1": "2915 Grant St",
"address_purpose": "LOCATION",
"city": "Omaha",
"state": "NE",
"postal_code": "681113863",
"country_code": "US",
"telephone_number": "402-451-3553",
"fax_number": "402-457-1220",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "CHARLES DREW HEALTH CENTER, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CHARLES DREW HEALTH CENTER INC",
"enumeration_date": "2019-05-03",
"last_updated": "2024-07-11",
"certification_date": "2024-07-11",
"status": "A",
"authorized_official_last_name": "STRINGFELLOW",
"authorized_official_first_name": "ANDRE",
"authorized_official_title_or_position": "CHEIF FINANCIAL OFFICER",
"authorized_official_telephone_number": "402-457-1215",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"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": "10026276410",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID-NON FQHC",
"identifier": "10026276411",
"state": "NE"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Charles Drew Health Center, Inc. at Highlander Accelerator",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "Charles Drew Health Center, Inc. at Highlander Accelerator",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.