NPIMap

Organization Active NPI

Community Health Alliance

  • Federally Qualified Health Center (FQHC)
  • Reno, NV
National Provider Identifier
1407463540
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH ALLIANCE
Practice address
680 S Rock Blvd
Reno, NV 89502-4113
Phone
(775) 329-6300
NPI assigned
Sep 23, 2020
Last updated
Jan 25, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY HEALTH ALLIANCEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Authorized official

Name
Jennifer Wheeler
Title
Cco
Phone
(775) 329-6300

Specialties & licenses 1

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

Addresses

Primary practice location

680 S Rock Blvd
Reno, NV 89502-4113

Mailing address

680 S Rock Blvd
Reno, NV 89502-4113
Phone (775) 329-6300

Other names 1

  • Medical Mobile Van Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040701000827 NV Part B Supplier - Clinic/Group Practice 3577540160 Receives reassigned benefits from 68 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Reno, NV; Sun Valley, NV; Sparks, NV
O20100709000663 NV Part A Provider - Federally Qualified Health Center (FQHC) 3577540160 1 other NPI on this enrollment
Practice locations: Reno, NV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407463540. Details of each certification follow.

Federally qualified health center certification: CCN 291868

Legal name
COMMUNITY HEALTH ALLIANCE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 7, 2020
Last certification
Oct 7, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 31, 1992 in NV
Enrollment address
680 S Rock Blvd
Reno, NV 89502-4113

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Part of
H a W C Inc

Locations

1055 S Wells Ave
Reno, NV 89502
Phone (775) 829-6300

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Daniel R Spogen Individual Corporate DirectorAt Large Member Aug 1, 2016
Bayo K Curry-Winchell Individual Corporate DirectorMember;Board of Directors Jan 1, 2022
Matthew Thorton Individual Corporate DirectorPresident Aug 1, 2016
Mathew Work Individual Corporate DirectorBoard of Directors Feb 1, 2022
Nathan Dupree Individual Corporate DirectorMember Board of Directors Sep 1, 2023
Sam King Individual Corporate OfficerCfo May 1, 2024
Oscar Dario Delgado Individual Corporate OfficerCeo Jul 1, 2021
Noemi Gomez Individual Corporate DirectorMember;Board of Directors Dec 1, 2022
Paul R Parent Individual Corporate DirectorBoard of Directors Feb 1, 2011
Jennifer Wheeler Individual Corporate OfficerChief Clinical Officer Jan 1, 2020
W-2 Managing EmployeeAd; Jan 1, 2020
Laura Martinez Individual Corporate OfficerVice President Sep 1, 2020
Alexsis Adams Individual Corporate DirectorTreasurer Apr 1, 2021

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 10

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": "1600819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1407463540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 S ROCK BLVD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895024113",
            "telephone_number": "775-329-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 S ROCK BLVD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895024113",
            "telephone_number": "775-329-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH ALLIANCE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HEALTH ALLIANCE",
        "enumeration_date": "2020-09-23",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CCO",
        "authorized_official_telephone_number": "775-329-6300"
    },
    "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": "Medical Mobile Van",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Medical Mobile Van",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.