Community Care I, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

COMMUNITY CARE I, INC.

Practice address

8153 Main Street
Old Fort, OH 44861

Phone

(419) 992-4231

Fax

(419) 992-4722

NPI assigned

Jul 10, 2006

Last updated

Oct 20, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Denise Woolley, CPMSM, CPCS

Title

Director, Medical Staff Services

Phone

(419) 334-6624

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

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.

• Aaron Burks, AUD

  • Audiologist
  • Old Fort, OH
  • NPI 1386885267
  NPD (past)
• Penny L Mullins, M.D.

  • Family Medicine Physician
  • Old Fort, OH
  • NPI 1730148099
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287532800000",
    "number": "1619901915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 S TAFT AVE",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434203200",
            "telephone_number": "419-334-6624",
            "fax_number": "419-334-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8153 MAIN STREET",
            "city": "OLD FORT",
            "state": "OH",
            "postal_code": "44861",
            "telephone_number": "419-992-4231",
            "fax_number": "419-992-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE I, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2010-10-20",
        "status": "A",
        "authorized_official_last_name": "WOOLLEY",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "DIRECTOR, MEDICAL STAFF SERVICES",
        "authorized_official_telephone_number": "419-334-6624",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPMSM, CPCS"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0238951",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aaron Burks, AUD
• Lisa A Gregg, LPN
• Penny L Mullins, M.D.
• Old Fort Local School District

• Family Medicine Physician in Old Fort, OH
• Providers in Old Fort, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.