NPIMap

Organization Active NPI

Community Health Centers of the Central Coast, Inc

Doing business as Community Health Centers-Arroyo Grande

  • Community Health Clinic/Center
  • Arroyo Grande, CA
National Provider Identifier
1598064008
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC
Doing business as
Community Health Centers-Arroyo Grande
Practice address
260 Station Way
Arroyo Grande, CA 93420-3359
Phone
(805) 473-6201
Fax
(805) 473-6291
NPI assigned
Mar 23, 2011
Last updated
Jan 23, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Authorized official

Name
Barbara Allen
Title
Business Office Manager
Phone
(805) 361-8014

Specialties & licenses 1

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

Addresses

Primary practice location

260 Station Way
Arroyo Grande, CA 93420-3359

Mailing address

2050 S Blosser Rd
Santa Maria, CA 93458
Phone (805) 361-8014

Other names 1

  • Community Health Centers-Arroyo Grande Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040115001161 CA Part B Supplier - Clinic/Group Practice 7416868120 Receives reassigned benefits from 236 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Santa Maria, CA; Paso Robles, CA; San Luis Obispo, CA; Templeton, CA; Oceano, CA; Arroyo Grande, CA; Atascadero, CA; Cambria, CA…
O20120328000443 CA Part A Provider - Federally Qualified Health Center (FQHC) 7416868120 Practice locations: Arroyo Grande, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1598064008. Details of each certification follow.

Federally qualified health center certification: CCN 551158

Legal name
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 28, 2012
Last certification
Mar 28, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 8, 1978 in CA
Enrollment address
260 Station Way
Arroyo Grande, CA 93420-3359

Other NPIs with the same Medicare PAC ID 22

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

View all 22

Other NPIs on the same Medicare enrollment 27

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

View all 27

National Provider Directory

National Provider Directory
Tax ID family
Comm HLTH CTRS CNTL CST22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

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
Bertha Campos Individual Corporate DirectorBoard Member May 1, 2020
Ronald E Castle Individual Corporate OfficerChief Executive Officer Jun 1, 1978 20%
W-2 Managing Employee Jun 1, 1978 100%
Barbara a Allen Individual W-2 Managing EmployeeBusniess Office Manager Jul 1, 1978 5%
William Gordon Individual Corporate DirectorBoard President May 1, 2020

Practitioners & affiliated clinicians

Practitioners 8

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": "1300838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548201600000",
    "number": "1598064008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 S BLOSSER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "93458",
            "telephone_number": "805-361-8014",
            "fax_number": "805-361-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 STATION WAY",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934203359",
            "telephone_number": "805-473-6201",
            "fax_number": "805-473-6291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-23",
        "last_updated": "2019-01-23",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "805-361-8014"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Health Centers-Arroyo Grande",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Health Centers-Arroyo Grande",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arroyo Grande, CA

Sources for this page

Verify at the official NPI Registry.