NPIMap

Organization Active NPI

Community Health Centers of the Central Coast Inc

  • Federally Qualified Health Center (FQHC)
  • Santa Maria, CA
National Provider Identifier
1629595038
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC
Practice address
1510 E Main St Ste 104
Santa Maria, CA 93454-4826
Phone
(805) 361-8014
NPI assigned
Aug 25, 2017
Last updated
Oct 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Authorized official

Name
Ronald E Castle
Title
Chief Executive Officer
Phone
(805) 361-8014

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1510 E Main St Ste 104
Santa Maria, CA 93454-4826

Mailing address

2050 S Blosser Rd
Santa Maria, CA 93458-7310
Phone (805) 361-8014

Other names 1

  • Community Health Centers Advanced Women's Health Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210924000821 CA Part A Provider - Federally Qualified Health Center (FQHC) 7416868120 Practice locations: Santa Maria, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629595038. Details of each certification follow.

Federally qualified health center certification: CCN A01024

Legal name
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC
Doing business as
COMMUNITY HEALTH CENTER ADVANCE WOMENS HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 12, 2021
Last certification
Jul 12, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 1, 1978 in CA
Enrollment address
1510 E Main St
Ste 104B
Santa Maria, CA 93454-4825

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

National Provider Directory

National Provider Directory
Tax ID family
Comm HLTH CTRS-Morro Bay22 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

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 Mar 1, 2021 5%
Ronald E Castle Individual Corporate OfficerChief Executive Officer Mar 1, 2021 5%
Barbara a Allen Individual W-2 Managing EmployeeDirector of Business Office Jul 1, 1978 5%
William Gordon Individual Corporate DirectorBoard Member Mar 1, 2021 5%

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": "1503619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634083200000",
    "number": "1629595038",
    "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": "934587310",
            "telephone_number": "805-361-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 E MAIN ST STE 104",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934544826",
            "telephone_number": "805-361-8014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-25",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A",
        "authorized_official_last_name": "CASTLE",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "805-361-8014"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Health Centers Advanced Women's Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.