NPIMap

Organization Active NPI

Central City Concern, Inc.

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
National Provider Identifier
1487944179
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CENTRAL CITY CONCERN, INC.
Practice address
709 NW Everett St
Portland, OR 97209-3517
Phone
(971) 269-2612
Fax
(503) 501-5679
NPI assigned
Apr 14, 2011
Last updated
Apr 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Authorized official

Name
Dr. Andrew Mendenhall, MDNPI 1053347591
Title
President & Ceo
Phone
(503) 294-1681

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

709 NW Everett St
Portland, OR 97209-3517

Mailing address

121 NW Everett St
Portland, OR 97209-4049
Phone (503) 294-1681

Other names 1

  • Community Engagement Program Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241007002449 OR Part A Provider - Federally Qualified Health Center (FQHC) 6103803259 Practice locations: Portland, OR

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1487944179. Details of each certification follow.

Federally qualified health center certification: CCN 381042

Legal name
CENTRAL CITY CONCERN, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 7, 2024
Last certification
Oct 7, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 12, 1978 in OR
Enrollment address
709 NW Everett St
Portland, OR 97209-3517

Federally qualified health center certification: CCN 381903

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
COMMUNITY ENGAGEMENT PROGRAM
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 29, 2008
Last certification
May 29, 2008
Ownership / control type
For profit – partnership
Facility address
709 NW Everett
Portland, OR 97209

Other NPIs with the same Medicare PAC ID 11

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

National Provider Directory

National Provider Directory

Locations

33 NW Broadway
Portland, OR 97209
Phone (503) 228-7419

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Jonathan Radmacher Individual Corporate OfficerBoard President Oct 20, 2010
Corporate DirectorBoard President Oct 20, 2010
Elisabeth Zeller Individual Corporate OfficerBoard Chair Feb 18, 2016
Corporate DirectorBoard Member Feb 18, 2016
Ann Remmers Individual Corporate DirectorBoard Member Jan 15, 2025
David Swartley Individual Corporate DirectorBoard Member Aug 18, 2021
Fernando Pena Individual Corporate OfficerBoard Secretary/Treasurer Apr 19, 2023
Corporate DirectorBoard Member Apr 19, 2023
Carrie Smith Individual Corporate DirectorBoard Member Mar 15, 2023
Andrew B Mendenhall Individual Corporate OfficerPresident & Ceo Jul 1, 2022
W-2 Managing EmployeePresident & Ceo Jul 1, 2022
Operational/Managerial ControlPresident & Ceo Jul 1, 2022
Peter Beyer Individual Corporate OfficerChief Financial Officer Sep 7, 2021
W-2 Managing EmployeeChief Financial Officer Sep 7, 2021
Operational/Managerial ControlChief Financial Officer Sep 7, 2021
Jenny Kim Individual Corporate DirectorBoard Member Aug 20, 2025
Mamie Gathard Individual Corporate DirectorBoard Member Sep 21, 2022
Katrina McPherson Individual Corporate DirectorBoard Member Feb 17, 2023
David Chen Individual Corporate OfficerGeneral Counsel Jul 6, 2021
W-2 Managing EmployeeGeneral Counsel Jul 6, 2021
Operational/Managerial ControlGeneral Counsel Jul 6, 2021
Phyusin Myint Individual Corporate DirectorBoard Member Aug 20, 2025
William Rasmussen Individual Corporate DirectorBoard Member Aug 20, 2025
Eric Fishman Individual Corporate DirectorBoard Member May 18, 2022
Stacie L Carney Individual Corporate DirectorBoard Member Oct 16, 2024
Rilla Delorier Individual Corporate OfficerBoard Chair Nov 26, 2018
Corporate DirectorBoard Secretary/Treasurer Nov 26, 2018
Caresse Sakagawa Individual Corporate DirectorBoard Member Sep 20, 2023
Marguerita Lightfoot Individual Corporate DirectorBoard Member Nov 20, 2024

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1302739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775692800000",
    "number": "1487944179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 NW EVERETT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972094049",
            "telephone_number": "503-294-1681",
            "fax_number": "503-294-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 NW EVERETT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093517",
            "telephone_number": "971-269-2612",
            "fax_number": "503-501-5679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL CITY CONCERN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-14",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A",
        "authorized_official_last_name": "MENDENHALL",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "503-294-1681",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Engagement Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.