NPIMap

Organization Active NPI

The Providence Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Providence, RI
National Provider Identifier
1669474102
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
THE PROVIDENCE COMMUNITY HEALTH CENTERS, INC.
Practice address
40 Candace St
Providence, RI 02908-3747
Phone
(401) 444-0550
Fax
(401) 444-0425
NPI assigned
Aug 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Authorized official

Name
Mr. Kevin Cabral
Title
Cfo
Phone
(401) 444-0400

Specialties & licenses 1

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

Addresses

Primary practice location

40 Candace St
Providence, RI 02908-3747

Mailing address

375 Allens Ave
Providence, RI 02905-5010
Phone (401) 444-0400

Other names 1

  • Capitol Hill Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030812000063 RI Part A Provider - Federally Qualified Health Center (FQHC) 9335050962 3 other NPIs on this enrollment
Practice locations: Providence, RI

Federally qualified health center certification: CCN 411818

Legal name
THE PROVIDENCE COMMUNITY HEALTH CENTERS INC.
Doing business as
CAPITOL HILL HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 26, 2004
Last certification
Jan 26, 2004
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Mar 1, 1976 in RI
Enrollment address
40 Candace St
Providence, RI 29083747

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 3

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

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
41D0702512Providence Community Health Centers40 Candace St, Providence, RI 02908Provider-performed microscopyOct 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
The Providence Community Health Centers Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Patricia Harmon Individual Corporate Director Jan 25, 2024
Brenda L Charpentier Individual W-2 Managing EmployeeCredentialing Specialist Jun 1, 2020
Michael Cancilliere Individual Corporate DirectorBoard Member Jan 1, 2015
Christina Zanfagna Individual Corporate DirectorBoard Member Jan 1, 1998
Meghan Hopkins Individual Corporate DirectorBoard Member Nov 16, 2023
Wendy Thomas Individual Corporate DirectorBoard Member Jan 1, 2014
Cassandra L Feeney Individual Corporate DirectorBoard Member Jan 1, 2016
Benjamin Miccinello Individual Corporate DirectorBoard Member Jan 27, 2025
Wilson O. Villamar Individual Corporate DirectorBoard Member Mar 1, 2025
J. Russell Corcoran Individual Corporate DirectorBoard Member Jan 1, 2022
Patti Osborne Individual Corporate DirectorBoard Member Jan 27, 2025
Merrill Thomas Individual Corporate OfficerPresident & Ceo Dec 12, 2003
Rafael Yepez Individual Corporate DirectorBoard Member Sep 28, 2023
Joseph Espat Individual Corporate DirectorBoard Member Mar 17, 2023
Kevin J Cabral Individual Corporate OfficerVP, Cfo Jun 1, 2020
Amber Bichun Individual Corporate DirectorBoard Member Oct 1, 2019
Byron Monge Individual Corporate DirectorBoard Member Aug 31, 2023

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 91

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

View all 91

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1669474102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 ALLENS AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055010",
            "telephone_number": "401-444-0400",
            "fax_number": "401-444-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CANDACE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029083747",
            "telephone_number": "401-444-0550",
            "fax_number": "401-444-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PROVIDENCE COMMUNITY HEALTH CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-15",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "CABRAL",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "401-444-0400",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "Capitol Hill Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.