NPIMap

Organization Active NPI

Community Health Centers of the Central Coast Inc

  • Federally Qualified Health Center (FQHC)
  • Lompoc, CA
National Provider Identifier
1326065103
Registry record updated Dec 12, 2023
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
1300 W Ocean Ave
Lompoc, CA 93436-5678
Phone
(805) 737-1169
Fax
(805) 737-1772
NPI assigned
Jul 16, 2006
Last updated
Dec 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Authorized official

Name
Barbara Allen
Title
Director of Business Office
Phone
(805) 361-8014

Specialties & licenses 1

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

Addresses

Primary practice location

1300 W Ocean Ave
Lompoc, CA 93436-5678

Mailing address

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

Other names 1

  • Community Health Centers Lompoc Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040115001161 CA Part B Supplier - Clinic/Group Practice 7416868120 Receives reassigned benefits from 236 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Santa Maria, CA; Paso Robles, CA; San Luis Obispo, CA; Templeton, CA; Oceano, CA; Arroyo Grande, CA; Atascadero, CA; Cambria, CA…
O20050804001109 CA Part A Provider - Federally Qualified Health Center (FQHC) 7416868120 Practice locations: Lompoc, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1326065103. Details of each certification follow.

Federally qualified health center certification: CCN 051013

Legal name
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC
Doing business as
COMMUNITY HEALTH CENTERS LOMPOC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 9, 2005
Last certification
Aug 9, 2005
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 4, 1978 in CA
Enrollment address
425 W Central Ave
Suites 201-203
Lompoc, CA 93436-2805

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

Other NPIs on the same Medicare enrollment 27

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

View all 27

National Provider Directory

National Provider Directory

Locations

1300 W Ocean Ave
Lompoc, CA 93436
Phone (805) 737-1169

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Bertha Campos Individual Corporate DirectorBoard Member Aug 4, 2005 5%
Linda L Costa Individual Corporate Officer Dec 1, 2017 5%
Ronald E Castle Individual Corporate OfficerChief Executive Officer Aug 8, 2005 15%
W-2 Managing Employee Sep 12, 1978
Barbara a Allen Individual W-2 Managing EmployeeBusiness Office Manager Nov 1, 2012 5%
William Gordon Individual Corporate DirectorBoard Member Nov 1, 2012 5%

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702339200000",
    "number": "1326065103",
    "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": "1300 W OCEAN AVE",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934365678",
            "telephone_number": "805-737-1169",
            "fax_number": "805-737-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS OFFICE",
        "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": "Community Health Centers Lompoc",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Community Health Centers Lompoc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lompoc, CA

Sources for this page

Verify at the official NPI Registry.