NPIMap

Organization Active NPI

Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Orlando, FL
National Provider Identifier
1083011639
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
7912 Forest City Rd
Orlando, FL 32810-2907
Phone
(407) 905-8827
Fax
(407) 905-8998
NPI assigned
Nov 25, 2014
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 NU Primary

Addresses

Primary practice location

7912 Forest City Rd
Orlando, FL 32810-2907

Mailing address

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170630000571 FL Part A Provider - Federally Qualified Health Center (FQHC) 4082515390 1 other NPI on this enrollment
Practice locations: Orlando, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083011639. Details of each certification follow.

Federally qualified health center certification: CCN 681099

Legal name
COMMUNITY HEALTH CENTERS, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 30, 2017
Last certification
Jun 30, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1974 in FL
Enrollment address
7912 Forest City Rd
Orlando, FL 32810-2907

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 1

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

National Provider Directory

National Provider Directory
Tax ID family
WNTR GRDN Family37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

View all 36

Ownership & related parties

All disclosed owners & managing parties 12

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 DirectorBoard of Director Jul 26, 2018
Melissa Singh Individual Corporate DirectorBoard of Director Aug 25, 2016
Karla Radka Individual Corporate Director Nov 30, 2014
Mark W Dickinson Individual Corporate OfficerExecutive VP/Cfo Mar 14, 2011
W-2 Managing EmployeeExecutive VP/Cfo Mar 14, 2011
Debra Andree Individual Corporate OfficerCeo Jun 30, 2013
Community Health Centers, Inc Organization, Winter Garden, FL Corporation, Non-profit Operational/Managerial Control Apr 25, 2017 100%
Timothy J McKinney Individual Corporate Director1St Vice Chair, Board of Director May 30, 2013
Gisela Laurent Individual Corporate DirectorBoard of Director Feb 22, 2018
Kathryn Jo Bailey Individual Corporate OfficerCoo Feb 3, 2019
W-2 Managing EmployeeCoo Feb 3, 2019
Darryl Owens Individual Corporate DirectorBoard of Director May 24, 2018
Jerry Kassab Individual Corporate DirectorBoard of Director Jun 22, 2017
Timothy Walker Individual Corporate OfficerBoard of Director May 15, 2015

Owners & managing parties with NPI records 15

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

View all 15

All facility ownership & control disclosures 3

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, 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 4

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

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1416873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517788800000",
    "number": "1083011639",
    "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": "407-905-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7912 FOREST CITY RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328102907",
            "telephone_number": "407-905-8827",
            "fax_number": "407-905-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-25",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.