NPIMap

Organization Active NPI

Community Health Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Bristol, CT
National Provider Identifier
1356676514
Registry record updated Feb 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CENTER INC.
Practice address
395 N Main St
Bristol, CT 06010-4924
Phone
(860) 585-5000
Fax
(860) 585-5050
NPI assigned
Oct 6, 2009
Last updated
Feb 5, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2013

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

Authorized official

Name
Margaret Flinter, APRNNPI 1992701122
Title
VP/Clinical Director
Phone
(860) 347-6971

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

395 N Main St
Bristol, CT 06010-4924

Mailing address

575 Main St 2ND Floor
Attn: Credentialing DPT
Middletown, CT 06457-2718
Phone (860) 347-6971

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091215000094 CT Part A Provider - Federally Qualified Health Center (FQHC) 0547169138 1 other NPI on this enrollment
Practice locations: Bristol, CT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356676514. Details of each certification follow.

Federally qualified health center certification: CCN 071862

Legal name
COMMUNITY HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 8, 2010
Last certification
Feb 8, 2010
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 1, 1972 in CT
Enrollment address
395N Main St
D/B/a the Community Health Center of Bristol
Bristol, CT 60108105

Other NPIs with the same Medicare PAC ID 13

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

View all 13

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
CHC of Meriden30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Locations

395 N Main St
Bristol, CT 06010
Phone (860) 585-5000

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Al Miles Individual Corporate Director Oct 9, 2008
Gary Reid Individual Corporate Director Sep 1, 2000
OtherBoard Member Nov 1, 1991
Charles Rose Individual W-2 Managing Employee Aug 26, 2009
Mark Bonney Individual Corporate Director Sep 1, 2000
OtherBoard Member Nov 1, 1991
Angela Anthony Individual Corporate Director Sep 1, 2003
OtherBoard Member Nov 1, 1991
Mark Masselli Individual Corporate OfficerPresident/Ceo May 1, 1972 100%
Corporate Director Sep 1, 2000
W-2 Managing Employee Sep 1, 2000
Donald J Case Individual Corporate Director Sep 1, 2000
OtherBoard Member Nov 1, 1991
David Vance Individual Corporate Director Sep 1, 2000
OtherBoard Member Nov 1, 1991
Terry Danaher Individual Corporate Director Sep 1, 2000
OtherBoard Member Nov 1, 1991
Maragaret Flinter Individual Corporate OfficerSenior VP/Clinical Director Nov 1, 1980 100%
Corporate Director Sep 1, 2000
W-2 Managing Employee Sep 1, 2000
Jill Maconi Individual Corporate Director Dec 15, 2008

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Community Health Center of DanburyDanbury, CT, CCN 071849 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2000
Community Health Center of EnfieldEnfield, CT, CCN 071850 Federally qualified health center 5% Or Greater Direct Ownership Interest Sep 1, 2000

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1254787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360022400000",
    "number": "1356676514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 MAIN ST 2ND FLOOR",
            "address_2": "ATTN: CREDENTIALING DPT",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572718",
            "telephone_number": "860-347-6971",
            "fax_number": "860-638-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 N MAIN ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104924",
            "telephone_number": "860-585-5000",
            "fax_number": "860-585-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-06",
        "last_updated": "2013-02-05",
        "status": "A",
        "authorized_official_last_name": "FLINTER",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "VP/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "860-347-6971",
        "authorized_official_credential": "APRN"
    },
    "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 Bristol, CT

Sources for this page

Verify at the official NPI Registry.