NPIMap

Organization Active NPI

Community Health Care

  • Community Health Clinic/Center
  • Spanaway, WA
National Provider Identifier
1497973663
Registry record updated Jun 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
COMMUNITY HEALTH CARE
Practice address
134 188TH St S
Spanaway, WA 98387-4618
Phone
(253) 847-2304
Fax
(253) 597-4556
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2019

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

Authorized official

Name
David Flentge
Title
Ceo
Phone
(253) 597-4550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X Primary

Addresses

Primary practice location

134 188TH St S
Spanaway, WA 98387-4618

Mailing address

1148 Broadway Ste 100
Tacoma, WA 98402-3518
Phone (253) 597-4550

Other names 1

  • Spanaway Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110228000555 WA Part A Provider - Federally Qualified Health Center (FQHC) 1850201559 Practice locations: Spanaway, WA

Federally qualified health center certification: CCN 501886

Legal name
COMMUNITY HEALTH CARE
Doing business as
SPANAWAY CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 2, 2004
Last certification
Dec 2, 2004
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 24, 1987 in WA
Enrollment address
134 188TH St S
Spanaway, WA 98387-4618

Other NPIs with the same Medicare PAC ID 12

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2121118Spanaway Clinic134 188TH St S, Spanaway, WA 98387Provider-performed microscopyApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Family Clinic34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

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

View all 33

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Francis Cathersal Individual Corporate OfficerCeo Apr 10, 1995
Corporate DirectorCeo Apr 10, 1995
W-2 Managing EmployeeCeo Apr 10, 1995
Gary Walmer Individual Corporate DirectorBoard Member May 8, 2007
Barbara Roy Individual W-2 Managing Employee Jan 19, 2011
David Flentge Individual Corporate Director Jan 19, 2011
W-2 Managing Employee Jan 19, 2011

Practitioners & affiliated clinicians

Practitioners 72

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 72

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559865600000",
    "number": "1497973663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1148 BROADWAY STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023518",
            "telephone_number": "253-597-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 188TH ST S",
            "city": "SPANAWAY",
            "state": "WA",
            "postal_code": "983874618",
            "telephone_number": "253-847-2304",
            "fax_number": "253-597-4556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2019-06-07",
        "status": "A",
        "authorized_official_last_name": "FLENTGE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "253-597-4550"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spanaway Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Spanaway Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Spanaway, WA

Sources for this page

Verify at the official NPI Registry.