NPIMap

Organization Active NPI

Community Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Rockville, MD
National Provider Identifier
1407388754
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY CLINIC INC
Practice address
2 Taft CT
Rockville, MD 20850-1307
Phone
(240) 753-7895
Fax
(301) 424-3948
NPI assigned
Mar 28, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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

Authorized official

Name
Kathleen A Knolhoff, M.P.H.
Title
Cheif Executive Officer & President
Phone
(240) 499-2609

Specialties & licenses 1

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

Addresses

Primary practice location

2 Taft CT
Rockville, MD 20850-1307

Mailing address

8630 Fenton St
Suite 1204
Silver Spring, MD 20910-3806
Phone (301) 340-7525

Other names 1

  • CCI Health & Wellness Services Doing business as

National Provider Directory

National Provider Directory

Locations

2 Taft Ct
Rockville, MD 20850
Phone (202) 695-5329

NPI Registry JSON

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490659200000",
    "number": "1407388754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8630 FENTON ST",
            "address_2": "SUITE 1204",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209103806",
            "telephone_number": "301-340-7525",
            "fax_number": "301-495-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 TAFT CT",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208501307",
            "telephone_number": "240-753-7895",
            "fax_number": "301-424-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-28",
        "last_updated": "2017-03-28",
        "status": "A",
        "authorized_official_last_name": "KNOLHOFF",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHEIF EXECUTIVE OFFICER & PRESIDENT",
        "authorized_official_telephone_number": "240-499-2609",
        "authorized_official_credential": "M.P.H."
    },
    "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": "CCI Health & Wellness Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; 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.