NPIMap

Organization Active NPI

Community Health Center of Cape Cod, Inc.

Doing business as Community Health Center of Cape Cod

  • Community Health Clinic/Center
  • Falmouth, MA
National Provider Identifier
1285836080
Registry record updated Aug 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
4WAE Issued in MA
Legal business name
COMMUNITY HEALTH CENTER OF CAPE COD, INC.
Doing business as
Community Health Center of Cape Cod
Practice address
210 Jones Rd
Falmouth, MA 02540-2974
Phone
(508) 477-7090
Fax
(508) 477-7028
NPI assigned
Jun 4, 2007
Last updated
Aug 1, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2011

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

Authorized official

Name
Ms. Karen Gardner
Title
Ceo
Phone
(508) 539-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 4WAE MA Primary

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 1

  • Community Health Center of Cape Cod Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110719000063 MA Part A Provider - Federally Qualified Health Center (FQHC) 4486699568 Practice locations: Falmouth, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285836080. Details of each certification follow.

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
CorporationNon-profit
Incorporated
Apr 3, 1997 in MA
Enrollment address
210 Jones Rd 22
Falmouth, MA 25402974

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 Health Center of Cape Cod Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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
Madeleine Wing Adler Individual Corporate DirectorBoard Member Nov 15, 2012 6.6%
Paul Smith Individual Corporate DirectorBoard Member Nov 15, 2014 6.6%
Gina Hotton Individual Corporate DirectorBoard Member Jan 15, 2011 6.6%
Rudolph Hunter Individual Corporate OfficerTreasurer, Member at Large Nov 1, 1999 6.6%
Beverly Jacobson Individual Corporate DirectorBoard Member Mar 1, 2015 6.6%
Bhawana Chitkara Individual Corporate Director Nov 1, 2020
Ann Marie B Richard Individual W-2 Managing EmployeeCfo Sep 1, 2012 6.6%
David Peterson Individual Corporate OfficerBoard President Nov 20, 2010 6.6%
Karen L Gardner Individual Corporate OfficerCeo Aug 1, 2003
W-2 Managing EmployeeCeo Aug 1, 2003 6.6%
Brenda Swithenbank Individual Corporate OfficerClerk Jan 15, 2009 6.6%

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312156800000",
    "number": "1285836080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 COMMERCIAL ST",
            "city": "MASHPEE",
            "state": "MA",
            "postal_code": "026496507",
            "telephone_number": "508-477-7090",
            "fax_number": "508-477-7028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 JONES RD",
            "city": "FALMOUTH",
            "state": "MA",
            "postal_code": "025402974",
            "telephone_number": "508-477-7090",
            "fax_number": "508-477-7028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTER OF CAPE COD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2011-08-01",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "508-539-6000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "MA",
            "license": "4WAE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Health Center of Cape Cod",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Falmouth, MA

Sources for this page

Verify at the official NPI Registry.