NPIMap

Organization Active NPI

Community Clinic, Inc

  • Federally Qualified Health Center (FQHC)
  • Greenbelt, MD
National Provider Identifier
1255179644
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY CLINIC, INC
Practice address
7615 Ora Glen Dr
Greenbelt, MD 20770-3642
Phone
(301) 340-7525
NPI assigned
Jul 18, 2024
Last updated
Jul 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Authorized official

Name
Alisa Brightley
Title
Lead Credentialing Specialist
Phone
(270) 297-6758

Specialties & licenses 1

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

Addresses

Primary practice location

7615 Ora Glen Dr
Greenbelt, MD 20770-3642

Mailing address

8665 Georgia Ave
Silver Spring, MD 20910-3405
Phone (301) 495-0318

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250611000684 MD Part A Provider - Federally Qualified Health Center (FQHC) 6204722614 Practice locations: Greenbelt, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255179644. Details of each certification follow.

Federally qualified health center certification: CCN 801015

Legal name
COMMUNITY CLINIC, INC
Doing business as
CCI HEALTH SERVICES
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 27, 2025
Last certification
May 27, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
7615 Ora Glen Drive
Cci Health Services
Greenbelt, MD 20770-3642

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Community Clinic Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

7615 Ora Glen Dr
Greenbelt, MD 20770
Phone (240) 650-0811

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Sonya Bruton Individual Corporate OfficerCeo/President Apr 1, 2020
Corporate DirectorCeo/President Apr 1, 2020
W-2 Managing EmployeeCeo/President Apr 1, 2020
Latechia Chambers Individual W-2 Managing EmployeeBilling/Provider Enrollment Coordin Dec 12, 2022

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Cci Health ServicesTakoma Park, MD, CCN 211886 Federally qualified health center Operational/Managerial Control (100%) Apr 1, 2020
Community Clinic, IncGreenbelt, MD, CCN 211928 Federally qualified health center Other Dec 19, 2017

Owned or controlled facilities with NPI records 2

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

NPI Registry JSON

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

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721260800000",
    "number": "1255179644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8665 GEORGIA AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209103405",
            "telephone_number": "301-495-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7615 ORA GLEN DR",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703642",
            "telephone_number": "301-340-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-18",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A",
        "authorized_official_last_name": "BRIGHTLEY",
        "authorized_official_first_name": "ALISA",
        "authorized_official_title_or_position": "LEAD CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "270-297-6758"
    },
    "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 Greenbelt, MD

Sources for this page

Verify at the official NPI Registry.