NPIMap

Organization Active NPI

Community Health Center of Cape Cod Inc

  • Emergency Care Clinic/Center
  • North Falmouth, MA
National Provider Identifier
1194485771
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
Legal business name
COMMUNITY HEALTH CENTER OF CAPE COD INC
Practice address
26 Edgerton Dr Unit B
North Falmouth, MA 02556-2820
Phone
(508) 477-7090
Fax
(508) 477-7028
NPI assigned
Dec 23, 2021
Last updated
Dec 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

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

Authorized official

Name
Karen L Gardner
Title
Ceo
Phone
(508) 539-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X Primary

Addresses

Primary practice location

26 Edgerton Dr Unit B
North Falmouth, MA 02556-2820

Mailing address

107 Commercial St
Mashpee, MA 02649-6507
Phone (508) 539-6000

Other names 1

  • Community Health Center of Cape Cod - North Falmouth Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220901003323 MA Part A Provider - Federally Qualified Health Center (FQHC) 4486699568 Practice locations: North Falmouth, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194485771. Details of each certification follow.

Federally qualified health center certification: CCN 221963

Legal name
COMMUNITY HEALTH CENTER OF CAPE COD, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 30, 2022
Last certification
Aug 30, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 3, 1997 in MA
Enrollment address
26 Edgerton Dr
North Falmouth, MA 25562820

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Community Health Center of Cape Cod Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

210 Jones Rd
#22
Falmouth, MA 02540
Phone (508) 540-2949

65 Town Hall Sq
Ste C
Falmouth, MA 02540
Phone (508) 540-7075

26 Edgerton Dr
Unit B
North Falmouth, MA 02556

90 Route 6A
Ste 4C
Sandwich, MA 02563
Phone (508) 873-1208

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
Wille Mebane Individual Corporate Director Apr 15, 2021
Madeleine Wing Adler Individual Corporate Director Nov 1, 2013
John Dawley Individual Corporate Officer Nov 1, 2021
Paul Smith Individual Corporate Director Nov 1, 2014
Gina Hotton Individual Corporate Officer Feb 1, 2011
Rudolph Hunter Individual Corporate OfficerTreasurer Nov 1, 2014
Bhawana Chitkara Individual Corporate Director Feb 20, 2021
Ann Marie B Richard Individual W-2 Managing Employee Aug 1, 2014
David Peterson Individual Corporate OfficerPresident Nov 1, 2014
Karen L Gardner Individual Corporate Director Aug 1, 2003
Otis Porter Individual Corporate Director Nov 1, 2013

Practitioners & affiliated clinicians

Practitioners 66

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.

View all 66

NPI Registry JSON

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

{
    "created_epoch": "1640217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640563200000",
    "number": "1194485771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 COMMERCIAL ST",
            "city": "MASHPEE",
            "state": "MA",
            "postal_code": "026496507",
            "telephone_number": "508-539-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 EDGERTON DR UNIT B",
            "city": "NORTH FALMOUTH",
            "state": "MA",
            "postal_code": "025562820",
            "telephone_number": "508-477-7090",
            "fax_number": "508-477-7028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTER OF CAPE COD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-23",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "508-539-6000"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Health Center of Cape Cod - North Falmouth",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Community Health Center of Cape Cod - North Falmouth",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in North Falmouth, MA

Sources for this page

Verify at the official NPI Registry.