NPIMap

Organization Active NPI

Comprehensive Community Action, Inc

  • Community Health Clinic/Center
  • Warwick, RI
National Provider Identifier
1609253335
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
1502 Issued in RI
Legal business name
COMPREHENSIVE COMMUNITY ACTION, INC
Practice address
2756 Post Rd Ste 103
Warwick, RI 02886-3003
Phone
(401) 562-2250
NPI assigned
May 1, 2015
Last updated
May 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Authorized official

Name
Justine Sands
Title
Cfo
Phone
(401) 562-2249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 1502 RI Primary

Addresses

Primary practice location

2756 Post Rd Ste 103
Warwick, RI 02886-3003

Mailing address

311 Doric Ave
Cranston, RI 02910-2903

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150817001045 RI Part A Provider - Federally Qualified Health Center (FQHC) 0749176055 Practice locations: Warwick, RI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609253335. Details of each certification follow.

Federally qualified health center certification: CCN 411848

Legal name
COMPREHENSIVE COMMUNITY ACTION, INC.
Doing business as
PRIMARY CARE PARTNERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 23, 2015
Last certification
Sep 23, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
2756 Post Rd 103
Warwick, RI 28863003

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Comprehensive Comm Acti7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Marcia a Lopresti Individual Corporate OfficerBoard Member Jul 1, 2006 9%
John N Bucci Individual Corporate OfficerBoard Member Jul 1, 2001 9%
Robin M Gervais Individual Corporate OfficerBoard Member Jul 1, 2001 9%
Jason P Bouchard Individual Corporate OfficerBoard Member Jul 1, 2008 9%
Marybeth Corrente Individual Corporate OfficerBoard Member Jul 1, 1996 9%
Chris Mansfield Individual Corporate OfficerCeo Jan 1, 2025 100%
Marjorie C Barrett Individual Corporate OfficerBoard Member Jul 1, 2006 9%
Margaret M Long Individual Corporate OfficerBoard Member Jul 1, 2001 9%
Jeanine M Marrocco Individual Corporate OfficerBoard Member Jul 1, 2008 9%
Gina Eubank Individual W-2 Managing EmployeeCoo Jan 1, 2025 100%

Practitioners & affiliated clinicians

Practitioners 6

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": "1430438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1609253335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 DORIC AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029102903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2756 POST RD STE 103",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028863003",
            "telephone_number": "401-562-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE COMMUNITY ACTION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-01",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "SANDS",
        "authorized_official_first_name": "JUSTINE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "401-562-2249"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "RI",
            "license": "1502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.