NPIMap

Organization Active NPI

Walnut Street Community Health Center Inc.

  • Dental Clinic/Center
  • Hagerstown, MD
National Provider Identifier
1194276832
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
WALNUT STREET COMMUNITY HEALTH CENTER INC.
Practice address
201 S Cleveland Ave
Hagerstown, MD 21740-5745
Phone
(301) 745-3777
Fax
(301) 393-3459
NPI assigned
Oct 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Authorized official

Name
Mr. David Becker
Title
Cfo
Phone
(301) 745-3777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

201 S Cleveland Ave
Hagerstown, MD 21740-5745

Mailing address

201 South Cleveland Ave.
Hagerstown, MD 21740
Phone (301) 745-3777

Other names 1

  • Family Healthcare of Hagerstown Doing business as

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
21D0893971Family Healthcare of Hagerstown201 S Cleveland Avenue, Hagerstown, MD 21740Certificate of waiverMay 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Walnut St Comm HLTH Ctr Inc7 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.

Locations

201 S Cleveland Ave
Hagerstown, MD 21740
Phone (301) 745-3777

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1476748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595376000000",
    "number": "1194276832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SOUTH CLEVELAND AVE.",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "21740",
            "telephone_number": "301-745-3777",
            "fax_number": "301-393-3459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S CLEVELAND AVE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405745",
            "telephone_number": "301-745-3777",
            "fax_number": "301-393-3459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALNUT STREET COMMUNITY HEALTH CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-18",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "301-745-3777",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Healthcare of Hagerstown",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Healthcare of Hagerstown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.