Charter Oak Health Center, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

CHARTER OAK HEALTH CENTER, INC.

Practice address

693 Bloomfield Ave Ste 101
Bloomfield, CT 06002-2489

Phone

(860) 550-7500

Fax

(860) 216-4164

NPI assigned

Mar 13, 2019

Organization subpart

Yes

Parent organization

CHARTER OAK HEALTH CENTER INC.As reported in NPPES

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

Authorized official

Name

Tim Powers

Title

Chief Compliance Officer

Phone

(860) 550-7500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Federally qualified health center certification: CCN 071943

Legal name

CHARTER OAK HEALTH CENTER, INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Feb 13, 2020

Last certification

Feb 13, 2020

Ownership / control type

For profit – corporation

Facility address

693 Bloomfield Ave Suite 101
Bloomfield, CT 06002

Part of

Charter Oak Health Center

Locations

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

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778198400000",
    "number": "1447719091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 GRAND ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061061541",
            "telephone_number": "860-550-7500",
            "fax_number": "860-550-7529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "693 BLOOMFIELD AVE STE 101",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060022489",
            "telephone_number": "860-550-7500",
            "fax_number": "860-216-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARTER OAK HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHARTER OAK HEALTH CENTER INC.",
        "enumeration_date": "2019-03-13",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A",
        "authorized_official_last_name": "POWERS",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "860-550-7500"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Federally Qualified Health Center (FQHC) in Bloomfield, CT
• Providers in Bloomfield, CT by specialty
• Federally Qualified Health Center (FQHC) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.