NPIMap

Organization Active NPI

Wheeler Clinic Inc.

  • Federally Qualified Health Center (FQHC)
  • Bristol, CT
National Provider Identifier
1548760119
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
WHEELER CLINIC INC.
Practice address
10 N Main St
Bristol, CT 06010-8122
Phone
(888) 793-3500
NPI assigned
Feb 20, 2018
Last updated
Sep 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Authorized official

Name
Athena Szczesniak
Title
Chief Financial Officer
Phone
(860) 793-4235

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Health Service Clinic/Center 261QH0100X

Addresses

Primary practice location

10 N Main St
Bristol, CT 06010-8122

Mailing address

91 Northwest Dr
Plainville, CT 06062-1534

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151105001962 CT Part A Provider - Federally Qualified Health Center (FQHC) 0345147153 1 other NPI on this enrollment
Practice locations: Bristol, CT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1548760119. Details of each certification follow.

Federally qualified health center certification: CCN 071916

Legal name
WHEELER CLINIC INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 28, 2015
Last certification
Dec 28, 2015
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Jan 8, 1968 in CT
Enrollment address
10N Main St
Bristol, CT 60106527

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 1

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

National Provider Directory

National Provider Directory
Tax ID family
Wheeler Clinic Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

10 N Main St
Bristol, CT 06010
Phone (860) 584-6555

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Francis L Vincent Individual Corporate Director Jan 27, 2015
Gary J Thomas Individual Corporate Director Sep 1, 2010
David R Hamelin Individual Corporate Director May 27, 2014
William J Torres Individual Corporate Director Sep 1, 2009
Mary C Rodier Individual Corporate Director Mar 24, 2015
Charles J Herbert Individual Corporate Director Sep 11, 2015
James J Moylan Individual Corporate Director Sep 1, 2013
Eslayda Conteras Individual Corporate Director Apr 28, 2015
Noelle M Ouellette Individual Corporate Director Jan 27, 2015
Sabrina Trocchi Individual Corporate OfficerPresident/Ceo Nov 1, 2019
Operational/Managerial ControlPresident/Ceo Nov 1, 2019 100%
Diana a Levsky Individual Corporate Director Sep 1, 2011
Steven a Biscoglio Individual Corporate Director Sep 1, 2009
Christine Elizabeth Skelly Individual Corporate Director Sep 1, 2011
Kelly a Phenix Individual Corporate Director Mar 24, 2015
Athena Szczesniak Individual Corporate OfficerChief Financial Officer Jan 30, 2017
W-2 Managing EmployeeChief Financial Officer Apr 25, 2005
Operational/Managerial ControlChief Financial Officer Jan 30, 2017
Pierre a Richard Individual Corporate Director Sep 1, 2011
William D Gombatz Individual Corporate Director Sep 1, 2009
Richard E Cartland Individual Corporate Director Sep 28, 2010
Dawn Hinckley Individual W-2 Managing Employee Mar 24, 2004

Practitioners & affiliated clinicians

Practitioners 1

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": "1519084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599782400000",
    "number": "1548760119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 NORTHWEST DR",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060621534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N MAIN ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060108122",
            "telephone_number": "888-793-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHEELER CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-20",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A",
        "authorized_official_last_name": "SZCZESNIAK",
        "authorized_official_first_name": "ATHENA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "860-793-4235"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

Verify at the official NPI Registry.