NPIMap

Organization Active NPI

Community Health & Wellness Center of Greater Torrington

  • Federally Qualified Health Center (FQHC)
  • Torrington, CT
National Provider Identifier
1245521970
Registry record updated Apr 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
PENDING Issued in CT
Legal business name
COMMUNITY HEALTH & WELLNESS CENTER OF GREATER TORRINGTON
Practice address
469 Migeon Ave
Torrington, CT 06790-4643
Phone
(860) 482-3038
Fax
(860) 482-3038
NPI assigned
Apr 28, 2011
Last updated
Apr 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2011

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

Authorized official

Name
Kathleen Grimaud, APRNNPI 1992772297
Title
Ceo
Phone
(860) 482-3038

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 1

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

Addresses

Primary practice location

469 Migeon Ave
Torrington, CT 06790-4643

Mailing address

469 Migeon Ave
Torrington, CT 06790-4643
Phone (860) 482-3038

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041229001052 CT Part A Provider - Federally Qualified Health Center (FQHC) 2365436847 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Torrington, CT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245521970. Details of each certification follow.

Federally qualified health center certification: CCN 071834

Legal name
COMMUNITY HEALTH AND WELLNESS CENTER OF GREATER TORRINGTON INC
Doing business as
COMMUNITY HEALTH & WELLNESS CENTER OF GREATER TORRINGTON
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 22, 2005
Last certification
Feb 22, 2005
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Feb 18, 2004 in CT
Enrollment address
469 Migeon Ave
Torrington, CT 67904643

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Community Health and Wellness Center of Greater Torrington5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Peter Duncan Individual Corporate Officer Jul 12, 2021
Joanne Borduas Individual Corporate Officer Apr 1, 2015
Operational/Managerial Control Apr 1, 2015
Joy Goldstone Individual Corporate Director Mar 19, 2017
Jennifer Kelley Individual Corporate Officer Jul 12, 2021
Edward Arum Individual Corporate Director Jan 1, 2016
Greg Briscon Individual Corporate Officer Jul 12, 2021
Joel Sekorski Individual Corporate Director Jun 15, 2011
Nicole Pelchat Individual Corporate Officer Jul 12, 2021
Lesa Vanotti Individual Corporate Director Mar 19, 2017
Gina Bunch Individual Corporate OfficerSecretary Jul 12, 2021

Practitioners & affiliated clinicians

Practitioners 19

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 19

NPI Registry JSON

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

{
    "created_epoch": "1303948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303948800000",
    "number": "1245521970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 MIGEON AVE",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "067904643",
            "telephone_number": "860-482-3038",
            "fax_number": "860-482-3038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "469 MIGEON AVE",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "067904643",
            "telephone_number": "860-482-3038",
            "fax_number": "860-482-3038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH & WELLNESS CENTER OF GREATER TORRINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-28",
        "last_updated": "2011-04-28",
        "status": "A",
        "authorized_official_last_name": "GRIMAUD",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "860-482-3038",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CT",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrington, CT

Sources for this page

Verify at the official NPI Registry.