NPIMap

Organization Active NPI

Community Health Resources, Inc.

  • Primary Care Clinic/Center
  • Enfield, CT
National Provider Identifier
1346700093
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
COMMUNITY HEALTH RESOURCES, INC.
Practice address
153 Hazard Ave
Enfield, CT 06082-4592
Phone
(860) 253-5020
Fax
(860) 253-5030
NPI assigned
Mar 20, 2019
Last updated
May 15, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2019

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

Authorized official

Name
Kim Kennedy
Title
Administrative Services Manager
Phone
(860) 697-3364

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

153 Hazard Ave
Enfield, CT 06082-4592

Mailing address

2 Waterside Xing Ste 401
Windsor, CT 06095-1587
Phone (860) 697-3364

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040301000155 CT Part B Supplier - Clinic/Group Practice 5597652149 Receives reassigned benefits from 229 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: East Hartford, CT; Willimantic, CT; Norwich, CT; Manchester, CT; Hartford, CT; Enfield, CT; Danielson, CT; Bloomfield, CT

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

1310 Main St
Willimantic, CT 06226
Phone (860) 456-0038

Practitioners & affiliated clinicians

Practitioners 26

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 26

NPI Registry JSON

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557878400000",
    "number": "1346700093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WATERSIDE XING STE 401",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951587",
            "telephone_number": "860-697-3364",
            "fax_number": "860-731-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 HAZARD AVE",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824592",
            "telephone_number": "860-253-5020",
            "fax_number": "860-253-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH RESOURCES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-20",
        "last_updated": "2019-05-15",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "ADMINISTRATIVE SERVICES MANAGER",
        "authorized_official_telephone_number": "860-697-3364"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.