Organization Active NPI

Community Health Centers of America

  • Federally Qualified Health Center (FQHC)
  • McFarland, CA
National Provider Identifier
1134094626
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CENTERS OF AMERICA
Practice address
733 3Rd St
MC Farland, CA 93250-1008
Phone
(661) 792-3097
Fax
(661) 792-3095
NPI assigned
Oct 6, 2025
Last updated
Oct 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Authorized official

Name
Jamie Dole
Title
Manager
Phone
(209) 441-8383

Specialties & licenses 1

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

Addresses

Primary practice location

733 3Rd St
MC Farland, CA 93250-1008

Mailing address

PO Box 3091
Modesto, CA 95353-3091

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230301002819 CA Part A Provider - Federally Qualified Health Center (FQHC) 3476813460 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: MC Farland, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1134094626. Details of each certification follow.

Federally qualified health center certification: CCN 051960

Legal name
COMMUNITY HEALTH CENTERS OF AMERICA
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 14, 2023
Last certification
Feb 14, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 25, 2016 in CA
Enrollment address
733 3Rd St
MC Farland, CA 93250-1008

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
Community Health Centers of4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Shantaraju Policepatil Individual Corporate OfficerPresent Apr 17, 2021
Gurdeep Singh Individual Corporate OfficerCoo May 26, 2016
W-2 Managing EmployeeCoo May 26, 2016
Nandeesh Veerappa Individual Corporate OfficerCmo May 26, 2016
Mrutyuniaya Hiremath Individual Corporate OfficerSecretary Mar 1, 2018
Lodeman Baza Individual Corporate DirectorBoard Member Mar 1, 2018
Connie Collins Individual Corporate DirectorBoard Member Mar 1, 2018
Rebecca Troy Individual Corporate DirectorBoard Member Nov 10, 2021
Gail Joanne Pioski Individual Corporate DirectorBoard Member Mar 1, 2018
Prashant Venkataiah Individual Corporate DirectorBoard Member Nov 1, 2021
Elizabeth Broomfield Individual Corporate DirectorBoard Member Mar 20, 2021
Isabel Crutchfield Individual Corporate DirectorBoard Member Dec 15, 2019
Hurbert Daniel Individual Corporate DirectorBoard Member Nov 27, 2021
Naresh Channaveerappa Individual Corporate OfficerCeo-Cfo May 26, 2016
Luis Orellana Individual Corporate DirectorBoard Member Mar 20, 2021

Owners & managing parties with NPI records 2

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": "1759708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760659200000",
    "number": "1134094626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3091",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953533091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 3RD ST",
            "city": "MC FARLAND",
            "state": "CA",
            "postal_code": "932501008",
            "telephone_number": "661-792-3097",
            "fax_number": "661-792-3095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS OF AMERICA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-06",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A",
        "authorized_official_last_name": "DOLE",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "209-441-8383"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McFarland, CA

Sources for this page

Verify at the official NPI Registry.