NPIMap

Organization Active NPI

Portland Community Health Center

Doing business as Moore Middle School

  • Federally Qualified Health Center (FQHC)
  • Portland, ME
National Provider Identifier
1093256380
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PORTLAND COMMUNITY HEALTH CENTER
Doing business as
Moore Middle School
Practice address
171 Auburn St
Portland, ME 04103-2131
Phone
(207) 874-2141
NPI assigned
Mar 20, 2017
Last updated
Jun 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Authorized official

Name
Ann Tucker
Title
Cfo
Phone
(207) 874-2141

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Obstetrics & Gynecology Physician 207V00000X

Addresses

Primary practice location

171 Auburn St
Portland, ME 04103-2131

Mailing address

180 Park Ave
Portland, ME 04102-2957
Phone (207) 874-2141

Other names 1

  • Moore Middle School Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Portland Community Health Center49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

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

View all 48

Locations

171 Auburn St
Portland, ME 04103
Phone (207) 874-8150

NPI Registry JSON

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686268800000",
    "number": "1093256380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 PARK AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022957",
            "telephone_number": "207-874-2141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 AUBURN ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032131",
            "telephone_number": "207-874-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-20",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "207-874-2141"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moore Middle School",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Moore Middle School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.