NPIMap

Organization Active NPI

Community Health Connection Inc

  • Primary Care Clinic/Center
  • Tulsa, OK
National Provider Identifier
1609623628
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
COMMUNITY HEALTH CONNECTION INC
Practice address
1001A E 3Rd St
Tulsa, OK 74120-2601
Phone
(918) 622-0641
Fax
(918) 622-4814
NPI assigned
May 6, 2024
Organization subpart
Yes
Parent organization
COMMUNITY HEALTH CONNECTION INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Authorized official

Name
Mary Beth Miller
Title
Cfo
Phone
(918) 710-4414

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1001A E 3Rd St
Tulsa, OK 74120-2601

Mailing address

2321 E 3Rd St
Tulsa, OK 74104-1831
Phone (918) 710-4403

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250707000735 OK Part A Provider - Federally Qualified Health Center (FQHC) 5991756397 Practice locations: Tulsa, OK

Federally qualified health center certification: CCN 371053

Legal name
COMMUNITY HEALTH CONNECTION, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 19, 2025
Last certification
Jun 19, 2025
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Enrollment address
1001 E 3Rd St
Tulsa, OK 74120-2601

Other NPIs with the same Medicare PAC ID 3

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
37D2304513Community Health Connection, Inc1001 East 3Rd St, Tulsa, OK 74120Certificate of waiverMay 13, 2028

National Provider Directory

National Provider Directory
Tax ID family
Comm HLTH Connection Inc4 organizations share this tax ID, including this one
Part of
Comm HLTH Connection Inc

Other organizations with this tax ID 3

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

Locations

12020 E 31st St
Tulsa, OK 74146
Phone (918) 622-0641

1001 E 3rd St
Tulsa, OK 74120
Phone (918) 622-0641

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Kate Neary-Pounds Individual Corporate OfficerCeo Feb 19, 2024
Mary Miller Individual Corporate OfficerCfo May 15, 2017
W-2 Managing Employee May 15, 2017

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
K-W Clinical Construction ProjectTulsa, OK, CCN 371873 Federally qualified health center Operational/Managerial Control Nov 18, 2011

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714953600000",
    "number": "1609623628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2321 E 3RD ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741041831",
            "telephone_number": "918-710-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001A E 3RD ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741202601",
            "telephone_number": "918-622-0641",
            "fax_number": "918-622-4814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CONNECTION INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HEALTH CONNECTION INC",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "918-710-4414"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.