NPIMap

Organization Active NPI

Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Clermont, FL
National Provider Identifier
1174022214
Registry record updated Feb 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CENTERS, INC
Practice address
2140 N Don Wickham Dr Ste C
Clermont, FL 34711-1923
Phone
(407) 905-8827
NPI assigned
Feb 5, 2018
Last updated
Feb 5, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2018

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

Authorized official

Name
Margaret Brennan
Title
President/Ceo
Phone
(407) 905-8827

Specialties & licenses 1

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

Addresses

Primary practice location

2140 N Don Wickham Dr Ste C
Clermont, FL 34711-1923

Mailing address

110 S Woodland St
Winter Garden, FL 34787-3546
Phone (407) 905-8827

Other practice location 1

2145 N Don Wickham Dr Ste C
Clermont, FL 34711-1909
Phone (407) 905-8827

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180316000207 FL Part A Provider - Federally Qualified Health Center (FQHC) 4082515390 Practice locations: Clermont, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174022214. Details of each certification follow.

Federally qualified health center certification: CCN 681120

Legal name
COMMUNITY HEALTH CENTERS, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 16, 2018
Last certification
Mar 16, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
2140 N Don Wickham Dr
Ste C
Clermont, FL 34711-1923

Other NPIs with the same Medicare PAC ID 14

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

View all 14

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2143970Community Health Centers Clermont2140 Don Wickham Dr Ste C, Clermont, FL 34711Certificate of waiverOct 2, 2027

National Provider Directory

National Provider Directory
Tax ID family
CHC Inc Apopka Fam HLTH37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

View all 36

Locations

509 Cagan View Rd
Clermont, FL 34714
Phone 40790588271028

225 N 1st St
Leesburg, FL 34748
Phone (352) 314-7400

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Nilmarie Zapata-Colon Individual Corporate Director Jul 26, 2018
Operational/Managerial Control2ND Vice Chairperson Jul 24, 2018 10%
Melissa Singh Individual Corporate DirectorBoard of Director Aug 25, 2016
Operational/Managerial Control1St Vice Chairperson Aug 25, 2016 10%
Mark W Dickinson Individual Corporate OfficerExecutive VP/Cfo Mar 14, 2011
W-2 Managing EmployeeExecutive VP/Cfo Mar 14, 2011
Debra Andree Individual Corporate OfficerChief Executive Officer Jan 12, 2020
Operational/Managerial ControlChief Executive Officer Jan 12, 2020 10%
Community Health Centers, Inc Organization, Winter Garden, FL Non-profit 5% Or Greater Direct Ownership Interest Mar 19, 2018 100%
Gisela Laurent Individual Corporate Director Feb 22, 2018
Operational/Managerial ControlDirector on Board Jun 22, 2018 10%
Darryl Owens Individual Corporate Director May 24, 2018
Operational/Managerial ControlDirector on Board May 24, 2018 10%
Kathy Rovito Individual Corporate DirectorDirector on Board Jun 1, 2024 10%
Dale Price Individual Corporate Director May 24, 2018
Operational/Managerial ControlDirector on Board May 24, 2018 10%
Jerry Kassab Individual Corporate Director Jun 22, 2017
Operational/Managerial ControlChairperson on Board Jun 17, 2017 10%
Timothy Walker Individual Corporate DirectorBoard of Director May 15, 2015
Operational/Managerial ControlSecretary of the Board May 15, 2015 10%

Owners & managing parties with NPI records 15

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

View all 15

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Community Health Centers, IncTavares, FL, CCN 681069 Federally qualified health center Operational/Managerial Control (100%) May 4, 2016
Community Health Centers, IncOrlando, FL, CCN 681099 Federally qualified health center Operational/Managerial Control (100%) Apr 25, 2017
Meadow Woods Health CenterOrlando, FL, CCN C11065 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 23, 2012

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1517788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517788800000",
    "number": "1174022214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S WOODLAND ST",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873546",
            "telephone_number": "407-905-8827",
            "fax_number": "407-905-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 N DON WICKHAM DR STE C",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111923",
            "telephone_number": "407-905-8827"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2145 N Don Wickham Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Clermont",
            "state": "FL",
            "postal_code": "347111909",
            "country_code": "US",
            "telephone_number": "407-905-8827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-05",
        "last_updated": "2018-02-05",
        "status": "A",
        "authorized_official_last_name": "BRENNAN",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "407-905-8827"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.