Organization Active NPI

Community Health Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Greensburg, PA
National Provider Identifier
1437794492
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CLINIC, INC.
Practice address
218 S Maple Ave
Greensburg, PA 15601-3200
Phone
(724) 335-3334
Fax
(724) 335-2283
NPI assigned
Nov 14, 2019
Last updated
Nov 14, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY HEALTH CLINIC, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

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

Authorized official

Name
Mrs. Raji Jayakrishnan
Title
Executive Director
Phone
(724) 889-2777

Specialties & licenses 1

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

Addresses

Primary practice location

218 S Maple Ave
Greensburg, PA 15601-3200

Mailing address

943 Fourth Ave
New Kensington, PA 15068-6409
Phone (724) 889-2779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050411000340 PA Part B Supplier - Clinic/Group Practice 5294772463 Receives reassigned benefits from 11 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greensburg, PA; New Kensington, PA; Vandergrift, PA
O20250619001813 PA Part A Provider - Federally Qualified Health Center (FQHC) 5294772463 Practice locations: Greensburg, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1437794492. Details of each certification follow.

Federally qualified health center certification: CCN D31038

Legal name
COMMUNITY HEALTH CLINIC, INC.
Doing business as
COMMUNITY HEALTH CLINIC, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 3, 2025
Last certification
Jun 3, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
218 S Maple Ave
Ste 102
Greensburg, PA 15601-3200

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

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
39D2176336Community Health Clinic, Inc218 South Maple Street, Suite 102, Greensburg, PA 15601Certificate of waiverDec 11, 2027

National Provider Directory

National Provider Directory
Tax ID family
Community Health Clinic Inc5 organizations share this tax ID, including this one
Part of
Community Health Clinic Inc

Other organizations with this tax ID 4

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

Locations

218 S Maple Ave
Greensburg, PA 15601
Phone (724) 335-3334

218 S Maple Ave
Ste 102
Greensburg, PA 15601
Phone (724) 204-1801

943 4th Ave
New Kensington, PA 15068
Phone (724) 335-3334

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Juanita Nealer Individual Corporate DirectorDirector Mar 1, 2020
Raji Jayakrishnan Individual Corporate DirectorExecutive Director Mar 1, 2020
Operational/Managerial ControlExecutive Director Mar 1, 2020
Mary Ann Greenlee Individual Corporate DirectorDirector Mar 1, 2020
William Hall Individual Corporate DirectorTreasurer Aug 2, 2007
Charles Kemp Individual Corporate Director Mar 1, 2020
Sarah Sanders Individual Corporate Director Mar 1, 2020
Community Health Clinic, Inc. Organization, New Kensington, PA Non-profit Operational/Managerial Control Mar 1, 2020
Thomas King Individual Corporate DirectorBoard Member / President Mar 1, 2020
Hollin West Individual Corporate DirectorBoard Member / Vice President Mar 1, 2020
Rick O'Domes Individual Corporate Director Mar 1, 2020
Brenda Bowman Individual Operational/Managerial ControlCfo Apr 26, 2010
Lilian Armstead Individual Corporate DirectorDirector Mar 1, 2020
Barbara Corsi Individual Corporate DirectorDirector Mar 1, 2020

Owners & managing parties with NPI records 1

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 8

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": "1573689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573689600000",
    "number": "1437794492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "943 FOURTH AVE",
            "city": "NEW KENSINGTON",
            "state": "PA",
            "postal_code": "150686409",
            "telephone_number": "724-889-2779",
            "fax_number": "724-335-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 S MAPLE AVE",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156013200",
            "telephone_number": "724-335-3334",
            "fax_number": "724-335-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CLINIC, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HEALTH CLINIC, INC.",
        "enumeration_date": "2019-11-14",
        "last_updated": "2019-11-14",
        "status": "A",
        "authorized_official_last_name": "JAYAKRISHNAN",
        "authorized_official_first_name": "RAJI",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "724-889-2777",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensburg, PA

Sources for this page

Verify at the official NPI Registry.