NPIMap

Organization Active NPI

Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Orlando, FL
National Provider Identifier
1033409123
Registry record updated Feb 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CENTERS, INC
Practice address
19108 E Colonial Drive
Orlando, FL 32820-0000
Phone
(407) 905-8827
Fax
(321) 221-2043
NPI assigned
Apr 11, 2011
Last updated
Feb 5, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2018

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

Authorized official

Name
Margaret Brennan
Title
President/Ceo
Phone
(407) 905-8827

Specialties & licenses 1

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

Addresses

Primary practice location

19108 E Colonial Drive
Orlando, FL 32820-0000

Mailing address

110 S Woodland St
Winter Garden, FL 34787-3546
Phone (407) 905-8827

Other identifiers 1

IdentifierTypeStateIssuer
029545123MedicaidFL

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040120000172 FL Part B Supplier - Clinic/Group Practice 4082515390 Receives reassigned benefits from 128 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winter Garden, FL; Tavares, FL; Orlando, FL; Leesburg, FL; Groveland, FL; Clermont, FL; Apopka, FL
O20120531000642 FL Part A Provider - Federally Qualified Health Center (FQHC) 4082515390 Practice locations: Orlando, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033409123. Details of each certification follow.

Federally qualified health center certification: CCN 101091

Legal name
COMMUNITY HEALTH CENTERS, INC
Doing business as
BITHLO FAMILY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 1, 2012
Last certification
Jun 1, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
19108 East Colonial Drive
Orlando, FL 32820-3701

Other NPIs with the same Medicare PAC ID 14

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

View all 14

Other NPIs on the same Medicare enrollment 15

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

View all 15

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
10D2030750Bithlo Family Health Center19108 E Colonial Dr, Orlando, FL 32820Certificate of waiverOct 3, 2027

National Provider Directory

National Provider Directory

Locations

13275 W Colonial Dr
Winter Garden, FL 34787
Phone (407) 614-5374

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Nilmarie Zapata-Colon Individual Corporate Director2ND Vice Chairperson Jul 26, 2018 10%
Melissa Singh Individual Corporate Director1St Vice Chairperson Aug 25, 2016 10%
Mark W Dickinson Individual Corporate OfficerVice President/Cfo Mar 14, 2011
Corporate DirectorVice President/Cfo Mar 14, 2011
W-2 Managing EmployeeVice President/Cfo Mar 14, 2011
Debra Andree Individual Corporate OfficerPresident & Chief Executive Officer Jan 12, 2020 10%
Gisela Laurent Individual Corporate DirectorBoard of Directors Feb 22, 2018 10%
Darryl Owens Individual Corporate DirectorBoard of Directors Dec 1, 2024 10%
Kathy Rovito Individual Corporate DirectorDirector on Board Jul 1, 2024 10%
Felicia Davis Individual Corporate DirectorTreasurer on Board Feb 1, 2021 10%
Dale Price Individual Corporate DirectorBoard of Directors May 24, 2018 10%
Jerry Kassab Individual Corporate DirectorChairperson Jun 22, 2017 10%
Timothy Walker Individual Corporate DirectorSecretary on Board May 15, 2015 10%

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Community Health Centers, IncTavares, FL, CCN 681069 Federally qualified health center Operational/Managerial Control (100%) May 4, 2016
Community Health Centers, IncOrlando, FL, CCN 681099 Federally qualified health center Operational/Managerial Control (100%) Apr 25, 2017
Community Health Centers, IncClermont, FL, CCN 681120 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Mar 19, 2018
Meadow Woods Health CenterOrlando, FL, CCN C11065 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 23, 2012

Owned or controlled facilities with NPI records 5

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

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517788800000",
    "number": "1033409123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S WOODLAND ST",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873546",
            "telephone_number": "407-905-8827",
            "fax_number": "321-221-2043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19108 E COLONIAL DRIVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328200000",
            "telephone_number": "407-905-8827",
            "fax_number": "321-221-2043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-11",
        "last_updated": "2018-02-05",
        "status": "A",
        "authorized_official_last_name": "BRENNAN",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "407-905-8827"
    },
    "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": "029545123",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.