NPIMap

Organization Active NPI

Community Health Net

  • Federally Qualified Health Center (FQHC)
  • Harborcreek, PA
National Provider Identifier
1336301092
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH NET
Practice address
5712 Iroquois Ave
Harborcreek, PA 16421
Phone
(814) 455-7222
Fax
(814) 456-2375
NPI assigned
Jun 25, 2008
Last updated
Apr 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Authorized official

Name
Craig Ulmer
Title
Ceo
Phone
(814) 454-4530

Specialties & licenses 1

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

Addresses

Primary practice location

5712 Iroquois Ave
Harborcreek, PA 16421

Mailing address

PO Box 369
Erie, PA 16512-0369
Phone (814) 454-4530

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031222000617 PA Part B Supplier - Clinic/Group Practice 1759290588 Receives reassigned benefits from 29 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Harborcreek, PA; Erie, PA; Girard, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336301092. Details of each certification follow.

  • CCN 391115 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 391115

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
COMMUNITY HEALTH NET
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 3, 2018
Last certification
Aug 3, 2018
Ownership / control type
For profit – corporation
Facility address
5712 Iroquois Avenue
Harborcreek, PA 16421

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory

Locations

1720 Holland St
Erie, PA 16503
Phone (814) 453-6073

2021 E 20th St
Erie, PA 16510
Phone (814) 453-6229

2922 State St
Erie, PA 16508
Phone (814) 240-1653

4401 Iroquois Ave
Erie, PA 16511
Phone (814) 454-4530

554 E 10th St
Erie, PA 16503
Phone (814) 452-0760

Practitioners & affiliated clinicians

Practitioners 32

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 32

NPI Registry JSON

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682035200000",
    "number": "1336301092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 369",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165120369",
            "telephone_number": "814-454-4530",
            "fax_number": "814-456-2375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5712 IROQUOIS AVE",
            "city": "HARBORCREEK",
            "state": "PA",
            "postal_code": "16421",
            "telephone_number": "814-455-7222",
            "fax_number": "814-456-2375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH NET",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-25",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A",
        "authorized_official_last_name": "ULMER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "814-454-4530"
    },
    "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 Harborcreek, PA

Sources for this page

Verify at the official NPI Registry.