NPIMap

Organization Active NPI

Health Care Center for the Homeless Inc

Doing business as Orange Blossom Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Orlando, FL
National Provider Identifier
1235213216
Registry record updated Aug 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
BUS0009641-003 Issued in FL
Legal business name
HEALTH CARE CENTER FOR THE HOMELESS INC
Doing business as
Orange Blossom Family Health Center
Practice address
232 N Orange Blossom TRL
Orlando, FL 32805-1612
Phone
(407) 428-5751
NPI assigned
Oct 25, 2006
Last updated
Aug 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2016

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

Authorized official

Name
Mr. Bakari F. Burns, MPH, MBA
Title
Ceo
Phone
(407) 428-5751

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X BUS0009641-003 FL Primary

Addresses

Primary practice location

232 N Orange Blossom TRL
Orlando, FL 32805-1612

Mailing address

232 N Orange Blossom TRL
Orlando, FL 32805-1612
Phone (407) 428-5751

Other identifiers 5

IdentifierTypeStateIssuer
BUS0009641-0003OtherFLCITY OF ORLANDO BUSINESS
687429100MedicaidFL
687429102MedicaidFL
687429101MedicaidFL
5000-127026OtherFLORANGE COUNTY BUSINESS LI

Other names 1

  • Orange Blossom Family Health Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040927000965 FL Part A Provider - Federally Qualified Health Center (FQHC) 6103895107 Practice locations: Orlando, FL
O20101019001089 FL Part B Supplier - Clinic/Group Practice 6103895107 Receives reassigned benefits from 106 practitioners
7 other NPIs on this enrollment
Practice locations: Kissimmee, FL; Orlando, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1235213216. Details of each certification follow.

Federally qualified health center certification: CCN 101963

Legal name
HEALTH CARE CENTER FOR THE HOMELESS INC
Doing business as
ORANGE BLOSSOM FAMILY HEALTH CENTER DBA
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 23, 2004
Last certification
Nov 23, 2004
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
May 27, 1993 in FL
Enrollment address
232 N Orange Blossom TRL
Orlando, FL 32805-1612

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Health Care Center for the14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

701 W Livingston St
Bldg 800
Orlando, FL 32805

Networks

  • HealthSun Health Plans Network

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Jason Rimes Individual Corporate DirectorBoard of Directors Aug 5, 2010
Selena Williams Individual Corporate DirectorBoard of Directors Dec 31, 2010
Bakari Burns Individual Corporate DirectorPresident/Ceo Nov 5, 2004
W-2 Managing EmployeePresident/Ceo Nov 5, 2004 100%
Cliff Morris Individual Corporate DirectorBoard of Directors Aug 5, 2010
Pierre Arsenec Individual Corporate DirectorBoard of Directors Dec 31, 2010
Chaney B Gordy Individual Corporate DirectorBoard of Directors Nov 5, 2004
Antonio Arias Individual Corporate DirectorBoard of Directors Aug 5, 2010

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 107

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 107

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471824000000",
    "number": "1235213216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 N ORANGE BLOSSOM TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328051612",
            "telephone_number": "407-428-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 N ORANGE BLOSSOM TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328051612",
            "telephone_number": "407-428-5751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH CARE CENTER FOR THE HOMELESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2016-08-22",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "BAKARI",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-428-5751",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPH, MBA"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "FL",
            "license": "BUS0009641-003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CITY OF ORLANDO BUSINESS",
            "identifier": "BUS0009641-0003",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "687429100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "687429102",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "687429101",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORANGE COUNTY BUSINESS LI",
            "identifier": "5000-127026",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orange Blossom Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.