NPIMap

Organization Active NPI

Community Care

  • Health Maintenance Organization
  • Clearlake, CA
National Provider Identifier
1669654091
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
COMMUNITY CARE
Practice address
14644B Lakeshore Dr
Clearlake, CA 95422-9290
Phone
(707) 995-1606
Fax
(707) 995-0309
NPI assigned
Nov 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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

Authorized official

Name
Cynthia McMath
Title
Executive Director
Phone
(707) 462-3041

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X Primary

Addresses

Primary practice location

14644B Lakeshore Dr
Clearlake, CA 95422-9290

Mailing address

14644B Lakeshore Dr
Clearlake, CA 95422-9290
Phone (707) 995-1606

Other identifiers 1

IdentifierTypeStateIssuer
7975326MedicaidCA

Other names 1

  • CCHAP Other name

National Provider Directory

National Provider Directory
Tax ID family
Community Care3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

14644B Lakeshore Dr
Clearlake, CA 95422
Phone (707) 995-1606

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196121600000",
    "number": "1669654091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14644B LAKESHORE DR",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954229290",
            "telephone_number": "707-995-1606",
            "fax_number": "707-995-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14644B LAKESHORE DR",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954229290",
            "telephone_number": "707-995-1606",
            "fax_number": "707-995-0309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-27",
        "last_updated": "2007-11-27",
        "status": "A",
        "authorized_official_last_name": "MCMATH",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "707-462-3041"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7975326",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCHAP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clearlake, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.