NPIMap

Organization Active NPI

Community Health Center of Pinellas Inc

Doing business as Community Health Center at St Petersburg

  • Federally Qualified Health Center (FQHC)
  • St Petersburg, FL
National Provider Identifier
1437550084
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CENTER OF PINELLAS INC
Doing business as
Community Health Center at St Petersburg
Evara Health
Practice address
612 Dr Martin L King St N
St Petersburg, FL 33705
Phone
(727) 824-8181
NPI assigned
Sep 12, 2014
Last updated
Jun 6, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY HEALTH CENTER OF PINELLAS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 6, 2025

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

Authorized official

Name
Edward Kucher
Title
Chief Regulatory Officer
Phone
(727) 824-8100

Specialties & licenses 1

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

Addresses

Primary practice location

612 Dr Martin L King St N
St Petersburg, FL 33705

Mailing address

PO Box 10549
St Petersburg, FL 33733-0549
Phone (727) 824-8181

Other identifiers 1

IdentifierTypeStateIssuer
029565521MedicaidFL

Other names 2

  • Community Health Center at St Petersburg Doing business as
  • Evara Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040131000031 FL Part B Supplier - Clinic/Group Practice 8527961028 Receives reassigned benefits from 135 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Largo, FL; Tarpon Springs, FL; St Petersburg, FL; Saint Petersburg, FL; Pinellas Park, FL; Dunedin, FL; Clearwater, FL
O20150204000845 FL Part A Provider - Federally Qualified Health Center (FQHC) 8527961028 Practice locations: Saint Petersburg, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1437550084. Details of each certification follow.

Federally qualified health center certification: CCN 681005

Legal name
COMMUNITY HEALTH CENTER OF PINELLAS INC
Doing business as
COMMUNITY HEALTH CENTERS AT ST PETERSBURG
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 4, 2015
Last certification
Feb 4, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 14, 1980 in FL
Enrollment address
612 Dr Martin Luther King Jr N St
Saint Petersburg, FL 33705-1403

Other NPIs with the same Medicare PAC ID 19

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

View all 19

Other NPIs on the same Medicare enrollment 18

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

View all 18

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2084940Evara Health612 Dr MLK Jr St N, Saint Petersburg, FL 33705Provider-performed microscopyOct 5, 2026

National Provider Directory

National Provider Directory
Tax ID family
Community Health Center of Pinellas Inc24 organizations share this tax ID, including this one
Part of
Community Health Center of Pinellas Inc

Other organizations with this tax ID 23

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

View all 23

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Joseph Smith Individual Corporate DirectorChair Jun 1, 2019
Elodie Dorso Individual Corporate OfficerCeo Feb 28, 2018 100%
W-2 Managing Employee Jan 1, 2005
Operational/Managerial ControlCeo Feb 28, 2018 100%
Alberto Lense Individual Corporate DirectorBoard of Directors Jul 1, 2022
Edward Kucher Individual Corporate DirectorCoo Feb 28, 2018
W-2 Managing EmployeeCoo Feb 27, 2017
Operational/Managerial ControlCoo Feb 28, 2018

Practitioners & affiliated clinicians

Practitioners 2

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": "1410480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749168000000",
    "number": "1437550084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10549",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337330549",
            "telephone_number": "727-824-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 DR MARTIN L KING ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33705",
            "telephone_number": "727-824-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTER OF PINELLAS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HEALTH CENTER OF PINELLAS INC",
        "enumeration_date": "2014-09-12",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A",
        "authorized_official_last_name": "KUCHER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "CHIEF REGULATORY OFFICER",
        "authorized_official_telephone_number": "727-824-8100"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029565521",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Health Center at St Petersburg",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Health Center at St Petersburg",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Evara Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.