NPIMap

Organization Active NPI

Community Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • East Moline, IL
National Provider Identifier
1669360459
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CARE INC
Practice address
3100 7TH St
East Moline, IL 61244-3262
Phone
(563) 336-3000
Fax
(563) 336-3125
NPI assigned
Jun 27, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Authorized official

Name
Thomas Bowman
Title
Ceo
Phone
(563) 336-3000

Specialties & licenses 1

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

Addresses

Primary practice location

3100 7TH St
East Moline, IL 61244-3262

Mailing address

500 W River Dr
Davenport, IA 52801-1014
Phone (563) 336-3000

Other names 1

  • Community Health Care Inc - Glenview Middle School Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031205000597 IL Part B Supplier - Clinic/Group Practice 9830008895 Receives reassigned benefits from 57 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: East Moline, IL; Rock Island, IL; Moline, IL
O20250922000933 IL Part A Provider - Federally Qualified Health Center (FQHC) 9830008895 Practice locations: East Moline, IL

Federally qualified health center certification: CCN C41048

Legal name
COMMUNITY HEALTH CARE INC
Doing business as
COMMUNITY HEALTH CARE INC- GLENVIEW MIDDLE SCHOOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 25, 2025
Last certification
Aug 25, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
3100 7TH St
East Moline, IL 61244-3262

Other NPIs with the same Medicare PAC ID 16

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

View all 16

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Communit Y Health Care17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Locations

1934 W 5th St
Davenport, IA 52802

4205 N Fairmount St
Davenport, IA 52806
Phone (563) 343-9095

4001 N Brady St
Davenport, IA 52806
Phone (563) 323-2748

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Sarah Moore Individual Corporate DirectorBoard Member Dec 2, 1984
Thomas John Bowman Individual Corporate OfficerCeo Jun 4, 2010
W-2 Managing EmployeeCeo Jun 4, 2010
Operational/Managerial ControlCeo Jun 4, 2010
Kevin Hagedorn Individual Corporate OfficerCfo Jun 2, 2014
W-2 Managing EmployeeCeo Jun 2, 2014
Kristin Humphries Individual Corporate DirectorBoard Member Nov 21, 2023
Lisa Randolph Individual Corporate DirectorBoard Member Nov 5, 2019
Timothy Dahl Individual Corporate DirectorBoard Member Nov 1, 2023
David Joseph Helscher Individual Corporate DirectorBoard Member Jul 2, 2019
Phyllis M Mullett Individual Corporate DirectorBoard Member Nov 5, 2019
Katie Spain Individual Corporate DirectorBoard Member Nov 5, 2019
Laiken Guldenpfenning Individual Corporate DirectorBoard Member Feb 25, 2025
Luekinna Hodges Individual Corporate DirectorBoard Member Nov 23, 2023
Daniel Lopez Individual Corporate DirectorBoard Member Nov 23, 2023
Nana Ouro-Agoro Individual Corporate DirectorBoard Member Dec 2, 1984
Darryl Dopson Individual Corporate DirectorBoard Member Nov 1, 2018

Practitioners & affiliated clinicians

Practitioners 85

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 85

NPI Registry JSON

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

{
    "created_epoch": "1750982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760918400000",
    "number": "1669360459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W RIVER DR",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528011014",
            "telephone_number": "563-336-3000",
            "fax_number": "563-336-3125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 7TH ST",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612443262",
            "telephone_number": "563-336-3000",
            "fax_number": "563-336-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-27",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "563-336-3000"
    },
    "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 Care Inc - Glenview Middle School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Moline, IL

Sources for this page

Verify at the official NPI Registry.