NPIMap

Organization Active NPI

Community Health Care

Doing business as Hilltop Regional Health Center

  • Community Health Clinic/Center
  • Tacoma, WA
National Provider Identifier
1407076110
Registry record updated Jun 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
COMMUNITY HEALTH CARE
Doing business as
Hilltop Regional Health Center
Practice address
1202 Martin Luther King Jr. Way
Tacoma, WA 98405
Phone
(253) 597-3813
Fax
(253) 597-3815
NPI assigned
Apr 26, 2007
Last updated
Jun 7, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2019

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

Authorized official

Name
Mr. David Flentge
Title
Ceo
Phone
(253) 597-4550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X Primary

Addresses

Primary practice location

1202 Martin Luther King Jr. Way
Tacoma, WA 98405

Mailing address

1148 Broadway Ste 100
Tacoma, WA 98402-3518
Phone (253) 597-4550

Other names 1

  • Hilltop Regional Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110228000284 WA Part A Provider - Federally Qualified Health Center (FQHC) 1850201559 Practice locations: Tacoma, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407076110. Details of each certification follow.

Federally qualified health center certification: CCN 501868

Legal name
COMMUNITY HEALTH CARE
Doing business as
HILLTOP REGIONAL HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 1, 2001
Last certification
Nov 1, 2001
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 24, 1987 in WA
Enrollment address
1202 Martin Luther King Jr Way
Tacoma, WA 98405-3926

Other NPIs with the same Medicare PAC ID 12

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

National Provider Directory

National Provider Directory
Tax ID family
Chcds-Lakewood Clinic34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

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

View all 33

Locations

1202 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 441-4742

Ownership & related parties

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
Alma Price Individual Corporate OfficerBoard Member Jan 1, 2022
Ken Repp Individual Corporate OfficerBoard Treasurer Jan 1, 2022
William Speaker Individual Corporate OfficerChairman of the Board Jan 1, 2022
James M Satt Individual Corporate OfficerBoard Member Jan 1, 2022
Marco Viniegra Individual Corporate OfficerBoard President Jan 1, 2022
Lynese Cammack Individual Corporate OfficerBoard Member Jan 1, 2022
Ladedria Griffin Stallworth Individual Corporate OfficerBoard Member Jan 1, 2022
David Flentge Individual Corporate OfficerPresident/Ceo Jan 19, 2011
W-2 Managing EmployeePresident/Ceo Jan 19, 2011
Boaz Kealy Individual Corporate OfficerBoard Member Jan 1, 2022
Katie Parker Individual Corporate OfficerBoard Secretary Jan 1, 2022

Practitioners & affiliated clinicians

Practitioners 4

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": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559865600000",
    "number": "1407076110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1148 BROADWAY STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023518",
            "telephone_number": "253-597-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 MARTIN LUTHER KING JR. WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98405",
            "telephone_number": "253-597-3813",
            "fax_number": "253-597-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2019-06-07",
        "status": "A",
        "authorized_official_last_name": "FLENTGE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "253-597-4550",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hilltop Regional Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.