Community Health Center of Cape Cod, Inc.
Organization Active NPI Community Health Clinic/Center · Falmouth, MA
NPI 1285836080 · NPPES record last updated Aug 1, 2011
Key facts
- NPI
- 1285836080
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Health Clinic/Center 261QC1500X
- License
- 4WAE (MA)
- Legal business name
- COMMUNITY HEALTH CENTER OF CAPE COD, INC.
- Practice address
- 210 Jones Rd
Falmouth, MA 02540-2974 - Phone
- (508) 477-7090
- Fax
- (508) 477-7028
- NPI assigned
- Jun 4, 2007
- Organization subpart
- No
Authorized official
- Name
- Ms. Karen Gardner
- Title
- Ceo
- Phone
- (508) 539-6000
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 10
Practitioners 41
-
Munir Ahmed, MD
-
Kristy Kedian Brown, D.O.
-
Pedro Henrique Fortes, MSN, FNP-C
-
Kimberly Haupt, NP
-
Vladimir Koren, MD
-
Hilary Santos, FNP
-
Nisha Topiwala, NP
-
Alex Jacob Weiner, MPH, FNP/PMHNP
-
Riley Ashe, LCSW
-
Maryanne C Bombaugh, M.D.
-
James F Brown, M.D.
-
Sarah Aisling Clifford, PHYSICIAN ASSISTANT
-
Alice Cook, MSW
-
Ryan Paul Golden, M.D.
-
Laura Ellen Kanter, PH.D.
-
Samuel S Kothalanka, M.D.
-
Bethany Lebish, RDN
-
Olivia Lieberman, FNP
-
Allison N Marrier, PMHNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Federally qualified health center certification: CCN 221902
- Legal name
- COMMUNITY HEALTH CENTER OF CAPE COD, INC.
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jul 7, 2011
- Last certification
- Jul 7, 2011
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Apr 3, 1997 in MA
- Enrollment address
- 210 Jones Rd 22
Falmouth, MA 25402974
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Madeleine Wing Adler |
Corporate Director |
Nov 15, 2012 | 6.6% |
| Paul Smith |
Corporate Director |
Nov 15, 2014 | 6.6% |
| Gina Hotton |
Corporate Director |
Jan 15, 2011 | 6.6% |
| Rudolph Hunter |
Corporate Officer |
Nov 1, 1999 | 6.6% |
| Beverly Jacobson |
Corporate Director |
Mar 1, 2015 | 6.6% |
| Bhawana Chitkara |
Corporate Director | Nov 1, 2020 | |
| Ann Marie B Richard |
W-2 Managing Employee |
Sep 1, 2012 | 6.6% |
| David Peterson |
Corporate Officer |
Nov 20, 2010 | 6.6% |
| Karen L Gardner |
Corporate Officer |
Aug 1, 2003 | |
| W-2 Managing Employee |
Aug 1, 2003 | 6.6% | |
| Brenda Swithenbank |
Corporate Officer |
Jan 15, 2009 | 6.6% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110719000063 | MA | Part a Provider - Federally Qualified Health Center (FQHC) | 4486699568 | Practice locations: Falmouth, MA |
National Provider Directory
- Tax ID family
- Community Health Center of Cape Cod Inc
Locations
107 Commercial St
Mashpee, MA 02649
Phone (508) 539-6000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Clinic/Center | 261QC1500X | 4WAE | MA | Yes |
Addresses
Primary practice location
210 Jones Rd
Falmouth, MA 02540-2974
Mailing address
107 Commercial St
Mashpee, MA 02649-6507
Phone (508) 477-7090
Other names
- Community Health Center of Cape Cod
Other providers in Falmouth, MA
- Wendy Cohen-Slate
- Katherine Collins
- Community Health Center of Cape Cod Inc
- Community Health Center of Cape Cod, Inc.
- Community Health Center of Cape Cod, Inc.
- Compass Circle Behavioral Health LLC
- Lisa J Condon
- Janine D Connors
- Convenientmd - FFS UC LLC
- Convenientmd LLC
All providers in Falmouth, MA · Community Health Clinic/Center in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.