NPIMap

Organization Active NPI

Charles River Community Health, Inc

Doing business as Charles River Community Health

  • Federally Qualified Health Center (FQHC)
  • Brighton, MA
National Provider Identifier
1114175916
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CHARLES RIVER COMMUNITY HEALTH, INC
Doing business as
Charles River Community Health
Practice address
495 Western Ave
Brighton, MA 02135-1007
Phone
(617) 783-0500
NPI assigned
Sep 4, 2008
Last updated
May 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Authorized official

Name
Matthew Lockwood Mullaney
Title
Ceo
Phone
(781) 400-6221

Specialties & licenses 1

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

Addresses

Primary practice location

495 Western Ave
Brighton, MA 02135-1007

Mailing address

495 Western Ave
Brighton, MA 02135-1007
Phone (617) 783-0500

Other identifiers 1

IdentifierTypeStateIssuer
110024306GMedicaidMA

Other names 2

  • Charles River Community Health Doing business as
  • Joseph M. Smith Community Health Center, Inc Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090319000437 MA Part A Provider - Federally Qualified Health Center (FQHC) 5294709812 Practice locations: Brighton, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114175916. Details of each certification follow.

Federally qualified health center certification: CCN 221892

Legal name
CHARLES RIVER COMMUNITY HEALTH, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 28, 2009
Last certification
Apr 28, 2009
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 10, 1970 in MA
Enrollment address
495 Western Ave
Brighton, MA 21351007

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Joseph M Smith7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Elizabeth Browne Individual Corporate DirectorCeo Dec 2, 2008
W-2 Managing EmployeeCeo Dec 2, 2008
Steven Kent Individual Corporate Officer Jan 1, 2017
Modupe Mohammed Individual Corporate Officer Mar 2, 2021
Lamine Savadogo Individual Corporate OfficerBoard Member Jan 1, 2019
Nelson Portilo Individual Corporate Officer May 4, 2020
Hyacinth McLaren Individual Corporate Director Dec 2, 2008
Stephanie Sunderland-Ramsey Individual Corporate Officer Jan 1, 2017
Julia Collins Individual Corporate Officer Jan 1, 2018
Robert Woodworth Individual Corporate OfficerTreasurer Jan 1, 2017
Elizabeth Whittemore Individual Corporate OfficerChair Jan 1, 2015
Susan Kearns Individual Corporate OfficerBoard Member Jan 1, 2001
Corporate Director Dec 2, 2008
Gabriela Canepa Individual Corporate Officer Jan 1, 2004
Corporate Director Dec 2, 2008
Graciela Alarcon Individual Corporate Officer Mar 2, 2021
Tracey Mangham Individual Corporate Director Dec 2, 2008
Nakpangi Johnson Individual Corporate Officer Apr 5, 2020
David B Duong Individual Corporate OfficerBoard Member Apr 5, 2020
Caroline Grossman Individual Corporate OfficerBoard Member Jan 1, 2011
Patrice McGregor Individual Corporate Officer Jan 1, 2010

Owners & managing parties with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778803200000",
    "number": "1114175916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 WESTERN AVE",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021351007",
            "telephone_number": "617-783-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 WESTERN AVE",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021351007",
            "telephone_number": "617-783-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES RIVER COMMUNITY HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-04",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A",
        "authorized_official_last_name": "LOCKWOOD MULLANEY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "781-400-6221"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110024306G",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charles River Community Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Joseph M. Smith Community Health Center, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Joseph M. Smith Community Health Center, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Brighton, MA

Sources for this page

Verify at the official NPI Registry.