NPIMap

Organization Active NPI

Walnut Street Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hagerstown, MD
National Provider Identifier
1497222103
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
WALNUT STREET COMMUNITY HEALTH CENTER, INC.
Practice address
221 E Baltimore St
Hagerstown, MD 21740-6109
Phone
(301) 745-3777
NPI assigned
Oct 31, 2018
Organization subpart
Yes
Parent organization
WALNUT STREET COMMUNITY HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Authorized official

Name
David F Becker
Title
Cfo
Phone
(301) 745-3777

Specialties & licenses 1

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

Addresses

Primary practice location

221 E Baltimore St
Hagerstown, MD 21740-6109

Mailing address

201 S Cleveland Ave
Hagerstown, MD 21740-5745
Phone (301) 745-3777

Other identifiers 1

IdentifierTypeStateIssuer
401662900MedicaidMD

Other names 1

  • Family Healthcare of Hagerstown Doing business as

National Provider Directory

National Provider Directory
Part of
Walnut St Comm HLTH Ctr Inc

NPI Registry JSON

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595376000000",
    "number": "1497222103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S CLEVELAND AVE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405745",
            "telephone_number": "301-745-3777",
            "fax_number": "301-393-3459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E BALTIMORE ST",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406109",
            "telephone_number": "301-745-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALNUT STREET COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALNUT STREET COMMUNITY HEALTH CENTER, INC.",
        "enumeration_date": "2018-10-31",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "301-745-3777"
    },
    "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": "401662900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Healthcare of Hagerstown",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Healthcare of Hagerstown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.