NPIMap

Organization Active NPI

Florida Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Port St Lucie, FL
National Provider Identifier
1346619244
Registry record updated Jun 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FLORIDA COMMUNITY HEALTH CENTERS, INC.
Practice address
3235 SW Port St Lucie Blvd
Suite 105
Port St Lucie, FL 34953-3405
Phone
(561) 844-9443
Fax
(561) 844-1013
NPI assigned
Sep 21, 2015
Last updated
Jun 17, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2016

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

Authorized official

Name
Dr. Michael F Gervasi, D.O.NPI 1043241375
Title
President & Ceo
Phone
(561) 844-9443

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Family Medicine Physician 207Q00000X
Obstetrics & Gynecology Physician 207V00000X
Pediatrics Physician 208000000X

Addresses

Primary practice location

3235 SW Port St Lucie Blvd
Suite 105
Port St Lucie, FL 34953-3405

Mailing address

5827 Corporate Way
West Palm Beach, FL 33407-2000
Phone (561) 844-9443

Other names 1

  • Darwin Square Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20151229000010 FL Part A Provider - Federally Qualified Health Center (FQHC) 9931017126 Practice locations: Port St Lucie, FL
O20160222001336 FL Part B Supplier - Clinic/Group Practice 9931017126 Receives reassigned benefits from 33 practitioners
Practice locations: Port St Lucie, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346619244. Details of each certification follow.

Federally qualified health center certification: CCN 681038

Legal name
FLORIDA COMMUNITY HEALTH CENTERS INC
Doing business as
DARWIN SQUARE CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 29, 2015
Last certification
Dec 29, 2015
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Jun 14, 1976 in FL
Enrollment address
3235 SW Port St. Lucie Blvd Suite 105
Port St Lucie, FL 34953-3405

Other NPIs with the same Medicare PAC ID 14

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

View all 14

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0299388Florida Community Health Centers Inc3235 SW Port St Lucie Blvd, Port Saint Lucie, FL 34953Certificate of waiverJan 23, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Eutris Delancy Individual Corporate DirectorBoard Member Feb 1, 2017
Brian Rucks Individual Corporate DirectorBoard Member May 1, 2002
Margaret V Russell Individual Corporate OfficerCfo Feb 26, 2020
Maria Valdez Individual Corporate DirectorBoard Member Jul 1, 2023
Kenneth Mills Individual Corporate DirectorBoard Member May 1, 2012
Wilhelmina Lewis Individual Corporate DirectorChief Medical Officer Jan 2, 2011
Karen Cotton Individual Corporate DirectorChair Jan 1, 2003
Donald Hart Individual Corporate OfficerBoard Member Jul 1, 2022
Marcia Ann Marie Franklyn Individual Corporate DirectorBoard Members Jan 12, 2026
Linda Tapia Individual Operational/Managerial Control Jan 1, 2020
Annita McKnight Individual Corporate DirectorBoard Member Jan 12, 2026
Janet Taylor Individual Corporate DirectorTreasurer Board Member Aug 1, 1994
Florida Community Health Centers Inc Organization, West Palm Beach, FL Corporation, Non-profit Operational/Managerial Control Dec 29, 2015

Owners & managing parties with NPI records 15

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

View all 15

All facility ownership & control disclosures 10

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Pahokee CHCPahokee, FL, CCN 101809 Federally qualified health center Operational/Managerial Control Apr 1, 2018
Indiantown CenterIndiantown, FL, CCN 101858 Federally qualified health center Operational/Managerial Control Apr 1, 2018
Moore Haven CenterMoore Haven, FL, CCN 101100 Federally qualified health center Operational/Managerial Control Apr 1, 2018
Stuart CenterStuart, FL, CCN 101113 Federally qualified health center Operational/Managerial Control Apr 1, 2018
Grace Women's Health CenterFort Pierce, FL, CCN 101139 Federally qualified health center Operational/Managerial Control Apr 1, 2018
Florida Community Health Centers IncFort Pierce, FL, CCN 681936 Federally qualified health center Operational/Managerial Control (100%) Aug 1, 2021
Florida Community Health Centers IncWest Palm Beach, FL, CCN 681951 Federally qualified health center Operational/Managerial Control Aug 1, 2021
Florida Community Health Centers IncPort St Lucie, FL, CCN 681955 Federally qualified health center Operational/Managerial Control Aug 1, 2021
Florida Community Health Centers IncBelle Glade, FL, CCN 101028 Federally qualified health center Operational/Managerial Control Sep 16, 2022
Florida Community Health Centers IncPort St Lucie, FL, CCN C11035 Federally qualified health center Operational/Managerial Control Jul 29, 2024

Owned or controlled facilities with NPI records 10

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 10

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 33

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 33

NPI Registry JSON

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

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466121600000",
    "number": "1346619244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5827 CORPORATE WAY",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072000",
            "telephone_number": "561-844-9443",
            "fax_number": "561-844-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3235 SW PORT ST LUCIE BLVD",
            "address_2": "SUITE 105",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349533405",
            "telephone_number": "561-844-9443",
            "fax_number": "561-844-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA COMMUNITY HEALTH CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-21",
        "last_updated": "2016-06-17",
        "status": "A",
        "authorized_official_last_name": "GERVASI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "561-844-9443",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Darwin Square Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.