NPIMap

Organization Active NPI

Healthreach Community Health Centers

Doing business as Rangeley Family Medicine

  • Federally Qualified Health Center (FQHC)
  • Rangeley, ME
National Provider Identifier
1497729750
Registry record updated Jul 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
E58728 Issued in ME
Legal business name
HEALTHREACH COMMUNITY HEALTH CENTERS
Doing business as
Rangeley Family Medicine
Practice address
42 Dallas Hill Rd
Rangeley, ME 04970
Phone
(207) 864-3303
Fax
(207) 864-2969
NPI assigned
Feb 14, 2006
Last updated
Jul 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2008

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

Authorized official

Name
Constance R Coggins
Title
President/Ceo
Phone
(207) 861-3407

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X E58728 ME Primary

Addresses

Primary practice location

42 Dallas Hill Rd
Rangeley, ME 04970

Mailing address

PO Box 569
42 Dallas Hill Road
Rangeley, ME 04970
Phone (207) 864-3947

Other identifiers 1

IdentifierTypeStateIssuer
137970110MedicaidME

Other names 1

  • Rangeley Family Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050830000804 ME Part B Supplier - Clinic/Group Practice 5496726523 Receives reassigned benefits from 7 practitioners
Practice locations: Rangeley, ME
O20101027000557 ME Part A Provider - Federally Qualified Health Center (FQHC) 5496726523 Practice locations: Rangeley, ME

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497729750. Details of each certification follow.

Federally qualified health center certification: CCN 201819

Legal name
HEALTHREACH COMMUNITY HEALTH CENTERS
Doing business as
RANGELEY FAMILY MEDICINE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 1, 1994
Last certification
Apr 1, 1994
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jul 1, 1999 in ME
Enrollment address
42 Dallas Hill Rd
Rangeley, ME 49704032

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

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Michelle Kelley Individual Corporate DirectorBoard Member Jan 3, 2023
Karen Sennett Individual Corporate DirectorBoard Member Jan 1, 2026
Jenny M Boyden Individual Corporate DirectorBoard Member Jan 1, 2024
Joanne E a Joy Individual Corporate DirectorBoard Member Jan 1, 2026
Melinda Corey Individual Corporate DirectorBoard Member Jan 1, 2026
James C Higgins Individual Corporate DirectorBoard Member Jan 3, 2023
Susan Tedrick Individual Corporate DirectorBoard Member Jan 8, 2025
John Opperman Individual Corporate DirectorBoard Member Jan 1, 2022
Buffy Higgins Individual Corporate DirectorBoard Member Mar 26, 2025
Donna Williams Individual Corporate OfficerFinance Director Jul 1, 2019
W-2 Managing EmployeeFinance Director Jul 1, 2019
Paul Forman Individual Corporate DirectorBoard Member Oct 1, 2025
Constance Coggins Individual Corporate OfficerPresident and Ceo Oct 27, 2006
W-2 Managing EmployeePresident and Ceo Oct 27, 2006
Paula Callan Individual Corporate DirectorBoard Member Mar 26, 2025

Practitioners & affiliated clinicians

Practitioners 7

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": "1139875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215388800000",
    "number": "1497729750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 569",
            "address_2": "42 DALLAS HILL ROAD",
            "city": "RANGELEY",
            "state": "ME",
            "postal_code": "04970",
            "telephone_number": "207-864-3947",
            "fax_number": "207-864-2969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 DALLAS HILL RD",
            "city": "RANGELEY",
            "state": "ME",
            "postal_code": "04970",
            "telephone_number": "207-864-3303",
            "fax_number": "207-864-2969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHREACH COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-14",
        "last_updated": "2008-07-07",
        "status": "A",
        "authorized_official_last_name": "COGGINS",
        "authorized_official_first_name": "CONSTANCE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "207-861-3407"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "ME",
            "license": "E58728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137970110",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rangeley Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rangeley, ME

Sources for this page

Verify at the official NPI Registry.