Community Health Center of Cape Cod Inc
Organization Active NPI Emergency Care Clinic/Center · North Falmouth, MA
NPI 1194485771 · NPPES record last updated Dec 27, 2021
Key facts
- NPI
- 1194485771
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Care Clinic/Center 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
- Organization subpart
- No
Authorized official
- Name
- Karen L Gardner
- Title
- Ceo
- Phone
- (508) 539-6000
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 10
Practitioners 70
-
Munir Ahmed, MD
-
Riley Ashe, LCSW
-
Maryanne C Bombaugh, M.D.
-
James F Brown, M.D.
-
Kristy Kedian Brown, D.O.
-
Sarah Aisling Clifford, PHYSICIAN ASSISTANT
-
Pedro Henrique Fortes, MSN, FNP-C
-
Ryan Paul Golden, M.D.
-
Kimberly Haupt, NP
-
Laura Ellen Kanter, PH.D.
-
Vladimir Koren, MD
-
Samuel S Kothalanka, M.D.
-
Olivia Lieberman, FNP
-
Allison N Marrier, PMHNP
-
Alyssa Mills, CNP
-
Helen Marie Price, FNP-C
-
Jessica Provo, MD
-
Marina A Rabin, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
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
- Corporation · Non-profit
- Incorporated
- Apr 3, 1997 in MA
- Enrollment address
- 26 Edgerton Dr
North Falmouth, MA 25562820
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Wille Mebane |
Corporate Director | Apr 15, 2021 | |
| Madeleine Wing Adler |
Corporate Director | Nov 1, 2013 | |
| John Dawley |
Corporate Officer | Nov 1, 2021 | |
| Paul Smith |
Corporate Director | Nov 1, 2014 | |
| Gina Hotton |
Corporate Officer | Feb 1, 2011 | |
| Rudolph Hunter |
Corporate Officer |
Nov 1, 2014 | |
| Bhawana Chitkara |
Corporate Director | Feb 20, 2021 | |
| Ann Marie B Richard |
W-2 Managing Employee | Aug 1, 2014 | |
| David Peterson |
Corporate Officer |
Nov 1, 2014 | |
| Karen L Gardner |
Corporate Director | Aug 1, 2003 | |
| Otis Porter |
Corporate Director | Nov 1, 2013 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220901003323 | MA | Part a Provider - Federally Qualified Health Center (FQHC) | 4486699568 | Practice locations: North Falmouth, MA |
National Provider Directory
- Tax ID family
- Community Health Center of Cape Cod Inc
Locations
123 Waterhouse Rd
Bourne, MA 02532
Phone (508) 539-6000
210 Jones Rd
#22
Falmouth, MA 02540
Phone (508) 540-2949
65 Town Hall Sq
Ste C
Falmouth, MA 02540
Phone (508) 540-7075
40 Steeple St
Mashpee, MA 02649
26 Edgerton Dr
North Falmouth, MA 02556
Phone (508) 356-3010
26 Edgerton Dr
Unit B
North Falmouth, MA 02556
90 Route 6A
Ste 4C
Sandwich, MA 02563
Phone (508) 873-1208
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Care Clinic/Center | 261QE0002X | Yes |
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
- Community Health Center of Cape Cod - North Falmouth
Other providers in North Falmouth, MA
- Christelle Bibo-Ekodi
- William Howard Braund
- Adam Matthew Brown
- Cape Cod Orthopedics and Sports Medicine PC
- Natalie L Chambers
- Erin R Denmark
- Dermatology of Cape Cod, PC
- Barry Richard Dest.Croix
- Morgan Dinello
- Courtney Anne Dipaolo Whelan
All providers in North Falmouth, MA · Emergency Care Clinic/Center in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.