NPIMap

Organization Active NPI

Charles Drew Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Omaha, NE
National Provider Identifier
1346597895
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CHARLES DREW HEALTH CENTER, INC
Practice address
5904 Henniger Avenue
Omaha, NE 68183-0001
Phone
(402) 457-1240
Fax
(402) 453-1970
NPI assigned
Aug 14, 2012
Organization subpart
Yes
Parent organization
CHARLES DREW HEALTH CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Authorized official

Name
Mr. Andre Stringfellow
Title
Chief Financial Officer
Phone
(402) 457-1215

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Community Health Clinic/Center 261QC1500X
Federally Qualified Health Center (FQHC) 261QF0400X NE Primary
Community Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LC1500X
Community Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LC1500X NE

Addresses

Primary practice location

5904 Henniger Avenue
Omaha, NE 68183-0001

Mailing address

PO Box 30019
2915 Grant Street
Omaha, NE 68111-3863
Phone (402) 451-3553

Other identifiers 2

IdentifierTypeStateIssuer
10026274700MedicaidNE
10026274800OtherNEMEDICAID NON FQHC

Other names 1

  • Charles Drew Health Center, Inc at Crown Tower Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Federally qualified health center certification: CCN 281826

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
CHARLES DREW HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 30, 2012
Last certification
Nov 30, 2012
Ownership / control type
For profit – partnership
Facility address
5904 Henniger Ave
Omaha, NE 68183

National Provider Directory

National Provider Directory
Part of
Benson Community Health Center

NPI Registry JSON

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

{
    "created_epoch": "1344902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720656000000",
    "number": "1346597895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30019",
            "address_2": "2915 GRANT STREET",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681113863",
            "telephone_number": "402-451-3553",
            "fax_number": "402-457-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5904 HENNIGER AVENUE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681830001",
            "telephone_number": "402-457-1240",
            "fax_number": "402-453-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES DREW HEALTH CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHARLES DREW HEALTH CENTER, INC",
        "enumeration_date": "2012-08-14",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A",
        "authorized_official_last_name": "STRINGFELLOW",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "402-457-1215",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NE",
            "license": null,
            "primary": true
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Community Health",
            "state": "NE",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026274700",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID NON FQHC",
            "identifier": "10026274800",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charles Drew Health Center, Inc at Crown Tower",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Charles Drew Health Center, Inc at Crown Tower",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.