NPIMap

Organization Active NPI

Community Health Centers of the Central Coast Inc

  • Federally Qualified Health Center (FQHC)
  • San Miguel, CA
National Provider Identifier
1295198356
Registry record updated Jan 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC
Practice address
1385 Mission St
San Miguel, CA 93451
Phone
(805) 467-2344
Fax
(805) 467-2334
NPI assigned
Apr 5, 2016
Last updated
Jan 21, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2019

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

Authorized official

Name
Ronald E Castle
Title
Chief Executive Officer
Phone
(805) 361-8014

Specialties & licenses 1

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

Addresses

Primary practice location

1385 Mission St
San Miguel, CA 93451

Mailing address

2050 S Blosser Rd
Santa Maria, CA 93458-7310
Phone (805) 361-8014

Other names 1

  • CHC San Miguel Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180102001471 CA Part A Provider - Federally Qualified Health Center (FQHC) 7416868120 Practice locations: San Miguel, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295198356. Details of each certification follow.

Federally qualified health center certification: CCN 921040

Legal name
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC
Doing business as
COMMUNITY HEALTH CENTERS SAN MIGUEL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 4, 2017
Last certification
Dec 4, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 1, 1978 in CA
Enrollment address
1385 Mission St
San Miguel, CA 93451

Other NPIs with the same Medicare PAC ID 22

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

View all 22

National Provider Directory

National Provider Directory
Tax ID family
Comm HLTH CTRS-Morro Bay22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Sam Orozco Individual Corporate DirectorBoard Member Treasurer Jul 5, 2017 1%
Bertha Campos Individual Corporate DirectorBoard Member Jul 5, 2017 1%
Lue Thao Individual Corporate OfficerChief Financial Officer May 1, 2022 5%
Ronald E Castle Individual W-2 Managing EmployeeChief Executive Officer Jul 1, 1978 10%
Barbara a Allen Individual W-2 Managing EmployeeBusiness Office Manager Jul 1, 1978 5%
William Gordon Individual Corporate DirectorBoard Member President Jul 5, 2017 1%

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548028800000",
    "number": "1295198356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 S BLOSSER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587310",
            "telephone_number": "805-361-8014",
            "fax_number": "805-361-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1385 MISSION ST",
            "city": "SAN MIGUEL",
            "state": "CA",
            "postal_code": "93451",
            "telephone_number": "805-467-2344",
            "fax_number": "805-467-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-05",
        "last_updated": "2019-01-21",
        "status": "A",
        "authorized_official_last_name": "CASTLE",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "805-361-8014"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHC San Miguel",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "CHC San Miguel",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Miguel, CA

Sources for this page

Verify at the official NPI Registry.