NPIMap

Vernon J Harris East End Community Health Center

Organization Active NPI Federally Qualified Health Center (FQHC) · Richmond, VA

NPI 1366920530 · NPPES record last updated Nov 17, 2022

Key facts

NPI
1366920530
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER
Practice address
1500 N Lombardy St
Richmond, VA 23220-1711
Phone
(804) 780-0840
Fax
(804) 780-0862
NPI assigned
Jul 31, 2018
Organization subpart
Yes
Parent organization (as reported)
VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER

Authorized official

Name
Mr. Tracy Causey, MSPH, MBA
Title
Ceo
Phone
(804) 253-1968

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Other NPIs on the same Medicare enrollment 7

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

Other NPIs with the same Medicare PAC ID 6

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

Corporate family (same tax ID) 4

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

Practitioners 58

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 58

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in VA

Federally qualified health center certification: CCN 491965

Legal name
VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER
Organization structure
Corporation · Non-profit
Incorporated
Mar 15, 1998 in VA
Enrollment address
1500 N Lombardy St
Richmond, VA 23220-1711

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Wilma Harris
Individual 		Corporate Director
Member		 Jul 24, 2012
Tracy Causey
Individual 		Corporate Director Jan 13, 2003
Operational/Managerial Control Jan 13, 2003
Deone McWilliams
Individual 		Corporate Director
Member		 Apr 24, 2018
Michelle Hall
Individual 		Corporate Director
Member		 Feb 26, 2013
Betty Drummond
Individual 		Corporate Director
Member		 Jul 25, 2017
Joseph Lyons
Individual 		Corporate Director
Member		 Apr 24, 2018
Cynthia Evans
Individual 		Corporate Director
Member		 Apr 24, 2018
Darrell Johnson
Individual 		Corporate Director
Treasurer		 Oct 27, 2014
Denizez Moss
Individual 		Corporate Director
Member		 Apr 24, 2018
Anna Ruth Staton
Individual 		Corporate Director
Secretary		 Oct 16, 2009

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040217000877 VA Part B Supplier - Clinic/Group Practice 9638064850 Receives reassigned benefits from 49 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: North Chesterfield, VA; Richmond, VA
O20181130001418 VA Part a Provider - Federally Qualified Health Center (FQHC) 9638064850 Practice locations: Richmond, VA

National Provider Directory

Tax ID family
Vernon J Harris East En (5 organizations share this tax ID)
Part of
Vernon J Harris East En

Locations

101 Cowardin Ave
Ste 102
Richmond, VA 23224
Phone (804) 232-7876

719 N 25th St
Richmond, VA 23223
Phone (804) 253-1969

2711 Byron St
Richmond, VA 23223
Phone (804) 525-1818

2025 E Main St
Ste 105
Richmond, VA 23223
Phone (804) 253-1968

Specialties & licenses

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

Addresses

Primary practice location

1500 N Lombardy St
Richmond, VA 23220-1711

Mailing address

2809 North Ave
Richmond, VA 23222-3647
Phone (804) 780-0840

Other names

  • Capital Area Health Network - Henderson Health Services Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 17, 2022.

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668643200000",
    "number": "1366920530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 NORTH AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232223647",
            "telephone_number": "804-780-0840",
            "fax_number": "804-329-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N LOMBARDY ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232201711",
            "telephone_number": "804-780-0840",
            "fax_number": "804-780-0862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER",
        "enumeration_date": "2018-07-31",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A",
        "authorized_official_last_name": "CAUSEY",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "804-253-1968",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPH, MBA"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capital Area Health Network - Henderson Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richmond, VA

All providers in Richmond, VA · Federally Qualified Health Center (FQHC) in Virginia

Sources for this page

Verify at the official NPI Registry.