Organization Active NPI

Genesis Community Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Delray Beach, FL
National Provider Identifier
1437930815
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GENESIS COMMUNITY HEALTH, INC.
Practice address
2455 W Atlantic Ave RM 5-107
Delray Beach, FL 33445-4425
Phone
(561) 266-0961
NPI assigned
Oct 11, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Authorized official

Name
Deanna Warren
Title
Ceo
Phone
(561) 806-6835

Specialties & licenses 1

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

Addresses

Primary practice location

2455 W Atlantic Ave RM 5-107
Delray Beach, FL 33445-4425

Mailing address

639 E Ocean Ave Ste 409
Boynton Beach, FL 33435-5017
Phone (561) 806-6835

Other identifiers 1

IdentifierTypeStateIssuer
006608619MedicaidFL

Other names 1

  • Atlantis High Other name

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
10D2145985Genesis Community Health, Inc2455 W Atlantic Ave, Delray Beach, FL 33445Certificate of waiverMar 19, 2028

National Provider Directory

National Provider Directory
Tax ID family
Atlantis High7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

2455 W Atlantic Ave
Rm 5107
Delray Beach, FL 33445
Phone (561) 266-0961

NPI Registry JSON

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

{
    "created_epoch": "1696982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1437930815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 E OCEAN AVE STE 409",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334355017",
            "telephone_number": "561-806-6835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 W ATLANTIC AVE RM 5-107",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334454425",
            "telephone_number": "561-266-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS COMMUNITY HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-11",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-806-6835"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006608619",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atlantis High",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.