NPIMap

Organization Active NPI

Community Action Committee of Pike County

  • Primary Care Clinic/Center
  • Jackson, OH
National Provider Identifier
1114194347
Registry record updated Sep 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
COMMUNITY ACTION COMMITTEE OF PIKE COUNTY
Practice address
14590 St RT 93
Family Health Center Jackson
Jackson, OH 45640
Phone
(740) 286-2826
NPI assigned
May 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2010

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

Authorized official

Name
Ray Roberts
Title
Executive Director
Phone
(740) 289-2371

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

14590 St RT 93
Family Health Center Jackson
Jackson, OH 45640

Mailing address

941 Market St
Piketon, OH 45661-9757
Phone (740) 289-2371

Other identifiers 1

IdentifierTypeStateIssuer
2864682MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040322000819 OH Part B Supplier - Public Health/Welfare Agency 3173432762 Receives reassigned benefits from 26 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jackson, OH; Waverly, OH; Piketon, OH; Portsmouth, OH

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Community Action Commit32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283904000000",
    "number": "1114194347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "941 MARKET ST",
            "city": "PIKETON",
            "state": "OH",
            "postal_code": "456619757",
            "telephone_number": "740-289-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14590 ST RT 93",
            "address_2": "FAMILY HEALTH CENTER JACKSON",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "45640",
            "telephone_number": "740-286-2826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY ACTION COMMITTEE OF PIKE COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2010-09-08",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "RAY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "740-289-2371"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2864682",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.