NPIMap

Organization Active NPI

Community Healthnet Inc

  • Federally Qualified Health Center (FQHC)
  • Gary, IN
National Provider Identifier
1497007876
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTHNET INC
Practice address
1015 N Shelby St
Gary, IN 46403-1446
Phone
(219) 880-1190
NPI assigned
Oct 9, 2012
Last updated
Apr 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Authorized official

Name
Janet Seabrook, MDNPI 1043227507
Title
Ceo
Phone
(219) 484-2442

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 IN Primary

Addresses

Primary practice location

1015 N Shelby St
Gary, IN 46403-1446

Mailing address

1021 W 5TH Ave
Gary, IN 46402-1703
Phone (219) 880-1190

Other names 1

  • Community HealthNet Miller Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060228000318 IN Part B Supplier - Clinic/Group Practice 6305852344 Receives reassigned benefits from 36 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gary, IN; Hammond, IN; Merrillville, IN
O20130906000875 IN Part A Provider - Federally Qualified Health Center (FQHC) 6305852344 Practice locations: Gary, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497007876. Details of each certification follow.

Federally qualified health center certification: CCN 151908

Legal name
COMMUNITY HEALTHNET INC
Doing business as
COMMUNITY HEALTHNET MILLER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 13, 2013
Last certification
Aug 13, 2013
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
Jun 17, 1998 in IN
Enrollment address
1015 N Shelby St
Gary, IN 46403-1446

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Community Healthnet Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Rise Ross-Ratney Individual Corporate OfficerBoard Vice President Jan 1, 2000
Lynn Thomaolsezewski Individual Corporate OfficerBoard Member Jan 1, 2008
Rita Daniels Individual Corporate Director Jan 1, 2012
Glenda Dexter-Brown Individual Corporate Director May 1, 2001
Richard Hug Individual Corporate Director Jan 1, 2008
Community Healthnet Inc Organization, Gary, IN Non-profit Other Jun 17, 1998
Don Bates Individual Corporate OfficerBoard Member Jan 1, 2004
Mimi Elizabeth Gardner Individual Corporate Director Feb 25, 2013
Louis Spann Individual Corporate Director Jan 1, 2005
Ramon Morton Individual Corporate OfficerBoard President Jan 1, 2004
Janet Seabrook Individual Corporate DirectorCeo Jun 17, 1998 100%
W-2 Managing EmployeeCeo Jun 17, 1998

Owners & managing parties with NPI records 8

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

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Calumet High SchoolGary, IN, CCN 151905 Federally qualified health center Other Jun 17, 1998
Community Healthnet MerrillvilleMerrillville, IN, CCN 151903 Federally qualified health center Other Jun 17, 1998
Community Healthnet OscHammond, IN, CCN 151904 Federally qualified health center Other (100%) Jun 17, 1998
Community Healthnet IncGary, IN, CCN 151068 Federally qualified health center Operational/Managerial Control (100%) Jun 17, 1998
Morton High SchoolHammond, IN, CCN 151179 Federally qualified health center Other Jun 17, 1998

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 2

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": "1349740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1497007876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W 5TH AVE",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464021703",
            "telephone_number": "219-880-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 N SHELBY ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464031446",
            "telephone_number": "219-880-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTHNET INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-09",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A",
        "authorized_official_last_name": "SEABROOK",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "219-484-2442",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community HealthNet Miller",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Community HealthNet Miller",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gary, IN

Sources for this page

Verify at the official NPI Registry.