Community Health Connections, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Fitchburg, MA
NPI 1477580827 · NPPES record last updated Aug 24, 2022
Key facts
- NPI
- 1477580827
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- License
- 4141 (MA)
- Legal business name
- COMMUNITY HEALTH CONNECTIONS, INC.
- Practice address
- 326 Nichols Rd
Fitchburg, MA 01420-1914 - Phone
- (978) 878-8100
- Fax
- (978) 878-8418
- NPI assigned
- Jun 28, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. John A Demalia
- Title
- President and Ceo
- Phone
- (978) 878-8510
Other NPIs on the same Medicare enrollment 5
Other NPIs with the same Medicare PAC ID 4
Related certifications (CCN) 1
Practitioners 150
-
Jennelle Anderson, CNP
-
Monique Anderson, LICSW
-
Akosua Asare, FNP
-
Tammy F Benoit, MA
-
Krystina Kacee Bonilla, FNP-BC
-
Michelle Boudreau, NP-C
-
Felicia Brown, LMHC
-
Tina Marie Capone, LICSW
-
Andrea Lynn Carr, O.D
-
Arni Bruno Vito Casareale, MA, LMHC
-
Carrie-Anne Hale Case, N.P.
-
John A Dadah, O.D
-
Kathleen Dantas-Dwyer, LICSW
-
Brianna Despres, FNP-C
-
Cheryl T Divito, D.O.
-
Jose Drasich, LMHC
-
Olha Duda, M.D.
-
Michaela Dumais, PMHNP
-
Faith Farnham, MSN, APRN, FNP-C
-
Lindsey Farnsworth, FNP
-
Mark Daniel Franciosa, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MA
Federally qualified health center certification: CCN 221845
- Legal name
- COMMUNITY HEALTH CONNECTIONS, INC
- Doing business as
- FITCHBURG COMMUNITY HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jan 1, 2002
- Last certification
- Jan 1, 2002
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- May 16, 1997 in MA
- Enrollment address
- 326 Nichols Rd
Fitchburg, MA 14201914
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Marylou Montalvo |
Corporate Director | Sep 1, 2009 | |
| Silas Dobson |
Corporate Director | Sep 1, 2009 | |
| Sheila Sykes |
Corporate Director | Sep 1, 2010 | |
| Rebecca Fischer |
Corporate Director | Sep 1, 2010 | |
| Adrienne McGlone |
Corporate Director |
Aug 27, 2012 | 100% |
| Amelia J Spiliotes |
Corporate Director | Sep 1, 2012 | |
| Operational/Managerial Control | Sep 1, 2012 | ||
| Emily Macrae |
Corporate Director | Mar 1, 2008 | |
| Alan Chuman |
Corporate Director | Sep 1, 2010 | |
| John a Demalia |
Corporate Officer |
Sep 2, 2013 | |
| Corporate Director |
Sep 2, 2013 | ||
| Operational/Managerial Control |
Sep 2, 2013 | ||
| Gregg Buckman |
Corporate Director |
Oct 1, 2012 | 100% |
| Jane Crocker |
Corporate Director | Mar 1, 2008 | |
| Patrick B Lavelle |
Corporate Officer |
Nov 11, 2013 | |
| Mary Giannetti |
Corporate Director | Sep 1, 2010 | |
| Paul Schiavitti |
Corporate Director |
Oct 1, 2012 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040422001136 | MA | Part B Supplier - Clinic/Group Practice | 8729074992 |
Receives reassigned benefits from 138 practitioners 5 other NPIs on this enrollment Practice locations: Fitchburg, MA; Leominster, MA; Gardner, MA |
| O20080923000262 | MA | Part a Provider - Federally Qualified Health Center (FQHC) | 8729074992 | Practice locations: Fitchburg, MA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Clinic/Center | 261QC1500X | MA | ||
| Federally Qualified Health Center (FQHC) | 261QF0400X | 4141 | MA | Yes |
Addresses
Primary practice location
326 Nichols Rd
Fitchburg, MA 01420-1914
Mailing address
326 Nichols Rd
Fitchburg, MA 01420-1914
Phone (978) 878-8100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| M21400 | Other | MA | LOCAL MEDICARE |
| 1319833 | Medicaid | MA |
Other names
- Community Health Connections, Inc.
Other providers in Fitchburg, MA
- Taylor Commesso
- Kaitlyn Commodore
- Commonwealth of Massachusetts
- Community Counseling Services LLC
- Community Health Connections, Inc.
- Community Health Connections, Inc.
- Complete Family Medicine PLLC
- Complete Physical Therapy & Wellness, LLC
- Comprehensive Outpatient Services, Inc
- Selah Condon
All providers in Fitchburg, MA · Federally Qualified Health Center (FQHC) in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.