NPIMap

Organization Active NPI

Community Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Davenport, IA
National Provider Identifier
1295053890
Registry record updated Apr 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CARE, INC
Practice address
4205 N Fairmount St
Davenport, IA 52806-3054
Phone
(563) 343-9095
Fax
(563) 336-3125
NPI assigned
May 7, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2013

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

Authorized official

Name
Thomas J Bowman
Title
Ceo
Phone
(563) 336-3000

Specialties & licenses 1

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

Addresses

Primary practice location

4205 N Fairmount St
Davenport, IA 52806-3054

Mailing address

500 W River Dr
Davenport, IA 52801-1014
Phone (563) 336-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040317000776 IA Part B Supplier - Clinic/Group Practice 9830008895 Receives reassigned benefits from 78 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Davenport, IA; Muscatine, IA; Clinton, IA

Other NPIs on the same Medicare enrollment 11

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

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1273190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367193600000",
    "number": "1295053890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W RIVER DR",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528011014",
            "telephone_number": "563-336-3000",
            "fax_number": "563-336-3125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 N FAIRMOUNT ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528063054",
            "telephone_number": "563-343-9095",
            "fax_number": "563-336-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-07",
        "last_updated": "2013-04-29",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "563-336-3000"
    },
    "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 Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.