NPIMap

Organization Active NPI

Charles Drew Health Center Inc

Doing business as Charles Drew Health Center Inc Mobile Medical

  • Federally Qualified Health Center (FQHC)
  • Omaha, NE
National Provider Identifier
1386218212
Registry record updated May 15, 2021
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
Doing business as
Charles Drew Health Center Inc Mobile Medical
Practice address
2915 Grant St
Omaha, NE 68111-3863
Phone
(402) 457-1200
Fax
(402) 939-0916
NPI assigned
May 15, 2021
Last updated
May 15, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
CHARLES DREW HEALTH CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 15, 2021

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

Authorized official

Name
Tarsha Jackson
Title
Chief Financial Officer
Phone
(402) 457-1215

Specialties & licenses 1

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

Addresses

Primary practice location

2915 Grant St
Omaha, NE 68111-3863

Mailing address

PO Box 111609
Omaha, NE 68111-5609
Phone (402) 457-1200

Other names 1

  • Charles Drew Health Center Inc Mobile Medical Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Charles Drew HLTH Ctr19 organizations share this tax ID, including this one
Part of
Charles Drew HLTH Ctr

Other organizations with this tax ID 18

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

View all 18

Practitioners & affiliated clinicians

Practitioners 112

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 112

NPI Registry JSON

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

{
    "created_epoch": "1621036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621036800000",
    "number": "1386218212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 111609",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681115609",
            "telephone_number": "402-457-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 GRANT ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681113863",
            "telephone_number": "402-457-1200",
            "fax_number": "402-939-0916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES DREW HEALTH CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHARLES DREW HEALTH CENTER INC",
        "enumeration_date": "2021-05-15",
        "last_updated": "2021-05-15",
        "certification_date": "2021-04-20",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "TARSHA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "402-457-1215"
    },
    "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": "Charles Drew Health Center Inc Mobile Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.