NPIMap

Organization Active NPI

The Providence Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Providence, RI
National Provider Identifier
1508868035
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
THE PROVIDENCE COMMUNITY HEALTH CENTERS, INC.
Practice address
239 Cranston St
Providence, RI 02907-2406
Phone
(401) 444-0580
Fax
(401) 444-0428
NPI assigned
Aug 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Authorized official

Name
Mr. Kevin Cabral
Title
Vice President/Chief Finance Office
Phone
(401) 444-0400

Specialties & licenses 1

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

Addresses

Primary practice location

239 Cranston St
Providence, RI 02907-2406

Mailing address

375 Allens Ave
Providence, RI 02905-5010
Phone (401) 444-0400

Other identifiers 1

IdentifierTypeStateIssuer
7001361MedicaidRI

Other names 1

  • Central Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20030812000060 RI Part A Provider - Federally Qualified Health Center (FQHC) 9335050962 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Providence, RI
O20030812000063 RI Part A Provider - Federally Qualified Health Center (FQHC) 9335050962 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Providence, RI
O20030812000065 RI Part A Provider - Federally Qualified Health Center (FQHC) 9335050962 1 other NPI on this enrollment
Practice locations: Providence, RI

Federally qualified health center certification: CCN 411801

Legal name
THE PROVIDENCE COMMUNITY HEALTH CENTERS INC.
Doing business as
PRAIRE AVENUE HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 1, 1976 in RI
Enrollment address
355 Prairie Ave
Providence, RI 29051928

Federally qualified health center certification: CCN 411818

Legal name
THE PROVIDENCE COMMUNITY HEALTH CENTERS INC.
Doing business as
CAPITOL HILL HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 26, 2004
Last certification
Jan 26, 2004
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Mar 1, 1976 in RI
Enrollment address
40 Candace St
Providence, RI 29083747

Federally qualified health center certification: CCN 411820

Legal name
THE PROVIDENCE COMMUNITY HEALTH CENTERS INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 26, 2004
Last certification
Jan 26, 2004
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Mar 1, 1976 in RI
Enrollment address
239 Cranston St
Providence, RI 29072406

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Patricia Harmon Individual Corporate DirectorBoard Member Jan 25, 2024
Corporate Director Jan 25, 2024
Brenda L Charpentier Individual W-2 Managing EmployeeCredentialing Specialist Jun 1, 2020
Michael Cancilliere Individual Corporate DirectorBoard Member Jan 1, 2015
Christina Zanfagna Individual Corporate DirectorBoard Member Jan 1, 1998
Meghan Hopkins Individual Corporate DirectorBoard Member Nov 16, 2023
Wendy Thomas Individual Corporate DirectorBoard Member Jan 1, 2010
Corporate DirectorBoard Member Jan 1, 2014
Cassandra L Feeney Individual Corporate DirectorBoard Member Jan 1, 2016
Benjamin Miccinello Individual Corporate DirectorBoard Member Jan 27, 2025
Wilson O. Villamar Individual Corporate DirectorBoard Member Mar 1, 2025
J. Russell Corcoran Individual Corporate DirectorBoard Member Jan 1, 2022
Patti Osborne Individual Corporate DirectorBoard Member Jan 27, 2025
Merrill Thomas Individual Corporate DirectorCeo Nov 3, 2003
W-2 Managing EmployeeCeo Nov 3, 2003
Corporate OfficerPresident & Ceo Dec 12, 2003
Corporate OfficerPresident & Ceo Jun 30, 1997
Rafael Yepez Individual Corporate DirectorBoard Member Sep 28, 2023
Joseph Espat Individual Corporate DirectorBoard Member Mar 17, 2023
Kevin J Cabral Individual Corporate OfficerVP, Cfo Jun 1, 2020
Amber Bichun Individual Corporate DirectorBoard Member Oct 1, 2019
Byron Monge Individual Corporate DirectorBoard Member Aug 31, 2023

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 90

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

View all 90

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1508868035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 ALLENS AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055010",
            "telephone_number": "401-444-0400",
            "fax_number": "401-444-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 CRANSTON ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029072406",
            "telephone_number": "401-444-0580",
            "fax_number": "401-444-0428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PROVIDENCE COMMUNITY HEALTH CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-15",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "CABRAL",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "VICE PRESIDENT/CHIEF FINANCE OFFICE",
        "authorized_official_telephone_number": "401-444-0400",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "7001361",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.