NPIMap

Organization Active NPI

East Chicago Community Health Center, Inc.

  • Multi-Specialty Clinic/Center
  • East Chicago, IN
National Provider Identifier
1154381739
Registry record updated Mar 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
EAST CHICAGO COMMUNITY HEALTH CENTER, INC.
Practice address
1313 W. Chicago Avenue
East Chicago, IN 46312-3316
Phone
(219) 397-1196
Fax
(219) 392-4981
NPI assigned
Mar 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2011

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

Authorized official

Name
Mr. Dwayne O Mitchell, MHA
Title
Chief Executive Officer
Phone
(219) 392-4900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1313 W. Chicago Avenue
East Chicago, IN 46312-3316

Mailing address

P.O. Box 59
East Chicago, IN 46312-0059
Phone (219) 397-1196

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Federally qualified health center certification: CCN 151843

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
EAST CHICAGO COMMUNITY HEALTH CENTER, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 12, 2006
Last certification
Oct 12, 2006
Ownership / control type
For profit – corporation
Facility address
1313 W Chicago Ave
East Chicago, IN 46312

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299715200000",
    "number": "1154381739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 59",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463120059",
            "telephone_number": "219-397-1196",
            "fax_number": "219-392-4981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 W. CHICAGO AVENUE",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463123316",
            "telephone_number": "219-397-1196",
            "fax_number": "219-392-4981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST CHICAGO COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-27",
        "last_updated": "2011-03-10",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "DWAYNE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "219-392-4900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MHA"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Chicago, IN

Sources for this page

Verify at the official NPI Registry.