NPIMap

Organization Active NPI

Community Health Net

  • Federally Qualified Health Center (FQHC)
  • Erie, PA
National Provider Identifier
1245209170
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH NET
Practice address
1202 State St
Erie, PA 16501-1914
Phone
(814) 455-7222
Fax
(814) 456-2375
NPI assigned
Mar 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Authorized official

Name
Craig A Ulmer
Title
Ceo
Phone
(814) 454-4530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1202 State St
Erie, PA 16501-1914

Mailing address

1202 State St
Erie, PA 16501-1914
Phone (814) 454-4530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031222000617 PA Part B Supplier - Clinic/Group Practice 1759290588 Receives reassigned benefits from 29 practitioners
6 other NPIs on this enrollment
Practice locations: Harborcreek, PA; Erie, PA; Girard, PA
O20050525000593 PA Part A Provider - Federally Qualified Health Center (FQHC) 1759290588 Practice locations: Erie, PA

Federally qualified health center certification: CCN 391865

Legal name
COMMUNITY HEALTH NET
Doing business as
DANIEL S SNOW MD HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 11, 1994
Last certification
May 11, 1994
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jan 25, 1985 in PA
Enrollment address
1202 State St
Erie, PA 16501-1914
Related CCNs
391824

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
Community Health Net6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Phil Cardella Individual Corporate OfficerChief Financial Officer Feb 1, 2022
W-2 Managing EmployeeChief Financial Officer Feb 1, 2022
Operational/Managerial ControlChief Financial Officer Feb 1, 2022
Craig Ulmer Individual Corporate OfficerCeo Mar 14, 2016
W-2 Managing Employee Mar 14, 2016
Operational/Managerial Control Mar 14, 2016
Linda Pinnell Individual W-2 Managing Employee Jan 11, 2019
Anthony R Ignocheck Individual Corporate DirectorMedical Director Oct 1, 2015

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 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701734400000",
    "number": "1245209170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 STATE ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165011914",
            "telephone_number": "814-454-4530",
            "fax_number": "814-459-6678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 STATE ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165011914",
            "telephone_number": "814-455-7222",
            "fax_number": "814-456-2375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH NET",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2023-12-05",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "ULMER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "814-454-4530"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.