NPIMap

Organization Active NPI

Generations Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Willimantic, CT
National Provider Identifier
1346228905
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
0228 Issued in CT
Legal business name
GENERATIONS FAMILY HEALTH CENTER, INC.
Practice address
40 Mansfield Ave
Willimantic, CT 06226-2018
Phone
(860) 450-7471
NPI assigned
Jan 4, 2006
Last updated
Apr 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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

Authorized official

Name
Mr. Arvind Shaw, M.B.A.
Title
Chief Executive Officer
Phone
(860) 450-7456

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 0228 CT
Federally Qualified Health Center (FQHC) 261QF0400X 0404 CT
Federally Qualified Health Center (FQHC) 261QF0400X 0374 CT
Federally Qualified Health Center (FQHC) 261QF0400X .321 CT
Federally Qualified Health Center (FQHC) 261QF0400X 0467 CT
Federally Qualified Health Center (FQHC) 261QF0400X 0228 CT Primary
Health Service Clinic/Center 261QH0100X 0228 CT
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 0467 CT

Addresses

Primary practice location

40 Mansfield Ave
Willimantic, CT 06226-2018

Mailing address

40 Mansfield Ave
Willimantic, CT 06226-2018
Phone (860) 450-7471

Other identifiers 3

IdentifierTypeStateIssuer
008003942MedicaidCT
004235695MedicaidCT
004235687MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20050324000979 CT Part B Supplier - Clinic/Group Practice 4880640630 Receives reassigned benefits from 8 practitioners
Practice locations: Willimantic, CT
O20060816000419 CT Part A Provider - Federally Qualified Health Center (FQHC) 4880640630 Practice locations: Willimantic, CT
O20060824000274 CT Part A Provider - Federally Qualified Health Center (FQHC) 4880640630 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Norwich, CT
O20060824000316 CT Part A Provider - Federally Qualified Health Center (FQHC) 4880640630 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Danielson, CT

NPI to CCN mapping 3

The Medicare certification numbers (CCNs) connected to NPI 1346228905. Details of each certification follow.

Federally qualified health center certification: CCN 071809

Legal name
GENERATIONS FAMILY HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 13, 1995
Last certification
Jan 13, 1995
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jul 12, 1991 in CT
Enrollment address
40 Mansfield Ave
Willimantic, CT 62262018

Federally qualified health center certification: CCN 071813

Legal name
GENERATIONS FAMILY HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 19, 1996
Last certification
Aug 19, 1996
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jul 12, 1991 in CT
Enrollment address
330 Washington St
Ste 510
Norwich, CT 63602733

Federally qualified health center certification: CCN 071818

Legal name
GENERATIONS FAMILY HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 16, 1996
Last certification
Aug 16, 1996
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jul 12, 1991 in CT
Enrollment address
42 Reynolds St
Danielson, CT 62392917

Other NPIs with the same Medicare PAC ID 3

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

23 Wauregan Rd
Brooklyn, CT 06234
Phone (860) 774-0876

42 Reynolds St
#340B164600
Danielson, CT 06239

54 Reynolds St
Danielson, CT 06239
Phone (860) 774-7501

202 Pomfret St
Putnam, CT 06260
Phone (860) 963-7917

202 Pomfret St
#340B164600
Putnam, CT 06260

37 Kennedy Dr
Putnam, CT 06260
Phone (860) 450-7471

40 Mansfield Ave
#340B164600
Willimantic, CT 06226

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Nancy Hinchey Individual Corporate DirectorBoard Member Jul 26, 2012
Corporate Director Jul 26, 2012
Arvind Shaw Individual Corporate OfficerChief Executive Officer May 18, 2001
W-2 Managing EmployeeChief Executive Officer May 18, 2001
Michael Bolton Individual Corporate DirectorBoard Member Oct 25, 2012
Corporate Director Oct 15, 2012
Cherie Poirier Individual Corporate DirectorBoard Member Sep 25, 2014
Corporate Director Sep 25, 2014
Jitendra Sinha Individual Corporate DirectorBoard Member Nov 16, 2017
Debra Savoie Individual W-2 Managing Employee Jun 28, 2006
Lisa Anderson Individual Corporate DirectorBoard Member Nov 17, 2016
Selma N. Ward Individual Corporate DirectorBoard Member Apr 27, 2017
Corporate DirectorChairperson Apr 27, 2017
Corporate OfficerChairperson Apr 27, 2017
Emmanuel Perez Deayala Individual Corporate DirectorBoard Member Mar 7, 2019
OtherVice-Chairperson Mar 7, 2019
Corporate OfficerVice Chair Person Mar 7, 2019
Beth Ober Individual Corporate DirectorBoard Member Oct 28, 2010
Corporate Director Oct 28, 2010
Giselle Lopez Individual Corporate Director Jun 2, 2022
Dina Dufort Individual Corporate Director Jun 3, 2021
April Burke Individual Corporate Director Apr 5, 2018
Nelson Walker Individual Other Nov 20, 2014
Corporate OfficerSecretary Nov 20, 2014
Melissa Meyers Individual Corporate Director Jan 3, 2023
Corporate DirectorChief Executive Officer Jan 3, 2023
Argentina Perez Individual Corporate Director Jan 28, 2016
Joan Marshall Individual Corporate Director May 5, 2022
Thomas Sullivan Individual Corporate Director Nov 16, 2023

Subparts reporting this organization as parent 4

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 9

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": "1136332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334707200000",
    "number": "1346228905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262018",
            "telephone_number": "860-450-7471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 MANSFIELD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262018",
            "telephone_number": "860-450-7471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERATIONS FAMILY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-04",
        "last_updated": "2012-04-18",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "ARVIND",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "860-450-7456",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.B.A."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CT",
            "license": "0228",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CT",
            "license": "0404",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CT",
            "license": "0374",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CT",
            "license": ".321",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CT",
            "license": "0467",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CT",
            "license": "0228",
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CT",
            "license": "0228",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CT",
            "license": "0467",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008003942",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004235695",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004235687",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willimantic, CT

Sources for this page

Verify at the official NPI Registry.