NPIMap

Organization Active NPI

Community Health and Dental Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Pottstown, PA
National Provider Identifier
1295994341
Registry record updated Feb 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
3293340 Issued in PA
Legal business name
COMMUNITY HEALTH AND DENTAL CARE, INC
Practice address
351 W Schuylkill Rd Ste G-15a
Pottstown, PA 19465-7438
Phone
(610) 326-9460
Fax
(610) 222-5006
NPI assigned
Jun 4, 2008
Last updated
Feb 15, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2019

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

Authorized official

Name
Bridget McGivern
Title
Chief Executive Officer
Phone
(610) 326-9460

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 3293340 PA
Federally Qualified Health Center (FQHC) 261QF0400X 3293340 PA Primary

Addresses

Primary practice location

351 W Schuylkill Rd Ste G-15a
Pottstown, PA 19465-7438

Mailing address

351 W Schuylkill Rd Ste G-15a
Pottstown, PA 19465-7438
Phone (610) 326-9460

Other names 1

  • Pottstown Area Health Center, Inc Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081112000554 PA Part B Supplier - Clinic/Group Practice 5395804827 Receives reassigned benefits from 68 practitioners
1 other NPI on this enrollment
Practice locations: Barto, PA; Boyertown, PA; Pottstown, PA
O20140416001126 PA Part A Provider - Federally Qualified Health Center (FQHC) 5395804827 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pottstown, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295994341. Details of each certification follow.

Federally qualified health center certification: CCN 391040

Legal name
COMMUNITY HEALTH AND DENTAL CARE INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 23, 2014
Last certification
Apr 23, 2014
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 23, 2005 in PA
Enrollment address
700 Heritage Dr
Ste 701
Pottstown, PA 19464-3297

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Locations

6 E Philadelphia Ave
Boyertown, PA 19512
Phone (610) 369-0606

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
Ruth Cole Individual Corporate DirectorBoard Secretary Dec 8, 2023
Jack Burns Individual Corporate DirectorBoard Treasurer Dec 8, 2023
Frank Buttaro Individual Corporate DirectorBoard Vice President Dec 8, 2023
Irene Shepherd Individual W-2 Managing EmployeeChief Medical Officer Apr 9, 2018 50%
Marta Pecharo Individual Corporate DirectorBoard President Dec 8, 2023
Bridget McGivern Individual W-2 Managing EmployeeChief Executive Officer Sep 7, 2010

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 71

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 71

NPI Registry JSON

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550188800000",
    "number": "1295994341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 W SCHUYLKILL RD STE G-15A",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194657438",
            "telephone_number": "610-326-9460",
            "fax_number": "484-941-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 W SCHUYLKILL RD STE G-15A",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194657438",
            "telephone_number": "610-326-9460",
            "fax_number": "610-222-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH AND DENTAL CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-04",
        "last_updated": "2019-02-15",
        "status": "A",
        "authorized_official_last_name": "MCGIVERN",
        "authorized_official_first_name": "BRIDGET",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "610-326-9460"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "PA",
            "license": "3293340",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "PA",
            "license": "3293340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pottstown Area Health Center, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Pottstown Area Health Center, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Pottstown, PA

Sources for this page

Verify at the official NPI Registry.