NPIMap

Organization Active NPI

Florida Community Health Centers, Inc.

Doing business as Florida Community Health Centers, Inc.- Lincoln Park

  • Federally Qualified Health Center (FQHC)
  • Fort Pierce, FL
National Provider Identifier
1205405271
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FLORIDA COMMUNITY HEALTH CENTERS, INC.
Doing business as
Florida Community Health Centers, Inc.- Lincoln Park
Practice address
3090 Ave G
Fort Pierce, FL 34947
Phone
(561) 844-9443
Fax
(561) 844-9443
NPI assigned
Jun 23, 2021
Last updated
Jun 23, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
FLORIDA COMMUNITY HEALTH CENTERS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Authorized official

Name
Wilhelmina N. LewisNPI 1134198344
Title
President & Ceo
Phone
(561) 844-9443

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Public Health DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223D0001X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Community Health Clinic/Center 261QC1500X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

3090 Ave G
Fort Pierce, FL 34947

Mailing address

5827 Corporate Way
West Palm Beach, FL 33407-2000
Phone (561) 844-9443

Other names 1

  • Florida Community Health Centers, Inc.- Lincoln Park Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040515000037 FL Part B Supplier - Clinic/Group Practice 9931017126 Receives reassigned benefits from 95 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Okeechobee, FL; West Palm Beach, FL; Stuart, FL; Port St. Lucie, FL; Port St Lucie, FL; Pahokee, FL; Moore Haven, FL; Indiantown, FL…
O20210922001833 FL Part A Provider - Federally Qualified Health Center (FQHC) 9931017126 Practice locations: Fort Pierce, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205405271. Details of each certification follow.

Federally qualified health center certification: CCN 681936

Legal name
FLORIDA COMMUNITY HEALTH CENTERS INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 22, 2021
Last certification
Sep 22, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 14, 1976 in FL
Enrollment address
3090 Ave G
Fort Pierce, FL 34947-0001

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

Other NPIs on the same Medicare enrollment 18

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 18

National Provider Directory

National Provider Directory
Tax ID family
Florida Comm HLTH CT in21 organizations share this tax ID, including this one
Part of
Florida Comm HLTH CT in

Other organizations with this tax ID 20

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

View all 20

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Eutris Delancy Individual Operational/Managerial Control Aug 1, 2021
Brian Rucks Individual Corporate DirectorTreasurer Aug 1, 2021
Margaret V Russell Individual Corporate OfficerCfo Aug 1, 2021
Maria Valdez Individual Corporate DirectorBoard Member Jul 1, 2023
Kenneth Mills Individual Corporate DirectorChair Aug 1, 2012
Wilhelmina Lewis Individual Corporate OfficerCeo Aug 1, 2021
Karen Cotton Individual Operational/Managerial ControlVice-Chair Aug 1, 2021
Donald Hart Individual Corporate DirectorBoard Member Jul 1, 2022
Marcia Ann Marie Franklyn Individual Corporate OfficerBoard Member Jan 12, 2026
Linda Tapia Individual Corporate DirectorVice-Chair Aug 1, 2021
Annita McKnight Individual Corporate DirectorBoard Member Jan 12, 2026
Janet Taylor Individual Corporate DirectorBoard Member Aug 1, 2021
Florida Community Health Centers Inc Organization, West Palm Beach, FL Non-profit Operational/Managerial Control Aug 1, 2021 100%

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 10

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

FacilityTypeRoleSince
Pahokee CHCPahokee, FL, CCN 101809 Federally qualified health center Operational/Managerial Control Apr 1, 2018
Indiantown CenterIndiantown, FL, CCN 101858 Federally qualified health center Operational/Managerial Control Apr 1, 2018
Moore Haven CenterMoore Haven, FL, CCN 101100 Federally qualified health center Operational/Managerial Control Apr 1, 2018
Stuart CenterStuart, FL, CCN 101113 Federally qualified health center Operational/Managerial Control Apr 1, 2018
Grace Women's Health CenterFort Pierce, FL, CCN 101139 Federally qualified health center Operational/Managerial Control Apr 1, 2018
Darwin Square CenterPort St Lucie, FL, CCN 681038 Federally qualified health center Operational/Managerial Control Dec 29, 2015
Florida Community Health Centers IncWest Palm Beach, FL, CCN 681951 Federally qualified health center Operational/Managerial Control Aug 1, 2021
Florida Community Health Centers IncPort St Lucie, FL, CCN 681955 Federally qualified health center Operational/Managerial Control Aug 1, 2021
Florida Community Health Centers IncBelle Glade, FL, CCN 101028 Federally qualified health center Operational/Managerial Control Sep 16, 2022
Florida Community Health Centers IncPort St Lucie, FL, CCN C11035 Federally qualified health center Operational/Managerial Control Jul 29, 2024

Owned or controlled facilities with NPI records 10

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

Facilities with the same owner 10

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

Practitioners & affiliated clinicians

Practitioners 7

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": "1624406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624406400000",
    "number": "1205405271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5827 CORPORATE WAY",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072000",
            "telephone_number": "561-844-9443",
            "fax_number": "561-844-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3090 AVE G",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "34947",
            "telephone_number": "561-844-9443",
            "fax_number": "561-844-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA COMMUNITY HEALTH CENTERS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FLORIDA COMMUNITY HEALTH CENTERS, INC.",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-04",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "WILHELMINA",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "561-844-9443"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florida Community Health Centers, Inc.- Lincoln Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.