NPIMap

Organization Active NPI

Access Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Madison, WI
National Provider Identifier
1669654307
Registry record updated Aug 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
37-800 Issued in WI
Legal business name
ACCESS COMMUNITY HEALTH CENTERS, INC.
Practice address
1102 S Park St
Madison, WI 53715-1714
Phone
(608) 443-5500
Fax
(608) 263-6663
NPI assigned
Dec 5, 2007
Last updated
Aug 3, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2016

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

Authorized official

Name
Joanne Holland
Title
Chief Financial Officer
Phone
(608) 443-5518

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 37-800 WI Primary

Addresses

Primary practice location

1102 S Park St
Madison, WI 53715-1714

Mailing address

2901 W Beltline Hwy
Suite 120
Madison, WI 53713-4226
Phone (608) 443-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041204000065 WI Part B Supplier - Clinic/Group Practice 0345153672 Receives reassigned benefits from 130 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sun Prairie, WI; Madison, WI
O20130715000657 WI Part A Provider - Federally Qualified Health Center (FQHC) 0345153672 1 other NPI on this enrollment
Practice locations: Madison, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669654307. Details of each certification follow.

Federally qualified health center certification: CCN 521849

Legal name
ACCESS COMMUNITY HEALTH CENTERS INC
Doing business as
ACCESS COMMUNITY HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 13, 2013
Last certification
Aug 13, 2013
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 19, 1982 in WI
Enrollment address
1102 S Park St
Madison, WI 53715-1708

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Access Community Health Centers Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2901 W Beltline Hwy
Ste 120
Madison, WI 53713
Phone (608) 443-5500

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Kenneth R Loving Individual Corporate OfficerCeo Feb 26, 2003
Patricia a Tellez Giron Individual Corporate DirectorBoard Director Jul 1, 2015
Pratik D. Prajapati Individual Corporate DirectorBoard Director Jul 1, 2015
Kristina F. Jones Individual Corporate DirectorBoard Director Jul 1, 2015
Sean J Laborde Individual Corporate DirectorBoard Director-VP Mar 1, 2012
Eva M Vivian Individual Corporate DirectorBoard Director Jul 1, 2015
Karen Menendez Collar Individual Corporate DirectorBoard Director Jul 1, 2015
Richard Donkel Individual Corporate DirectorBoard Director-Treasurer Jul 1, 2015
Joanne Holland Individual Corporate OfficerCeo Oct 1, 1996
W-2 Managing EmployeeCfo May 1, 2013
Anthony B. Cooper Individual Corporate DirectorBoard Director Jul 1, 2015
Jack S Bowhan Individual Corporate DirectorBoard Director Jul 1, 2011
Charlestine Daniel Individual Corporate DirectorBoard Director-Secretary Jul 1, 2015
Aleksander Kladnitsky Individual Corporate DirectorBoard Director Jul 1, 2015
Hamang B Patel Individual Corporate DirectorBoard Director-President Sep 1, 2012
Thomas J Hirsch Individual Corporate DirectorBoard Director Jan 1, 2012
Sean a. Saiz Individual Corporate DirectorBoard Director Jul 1, 2015

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 120

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.

View all 120

NPI Registry JSON

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470182400000",
    "number": "1669654307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 W BELTLINE HWY",
            "address_2": "SUITE 120",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537134226",
            "telephone_number": "608-443-5500",
            "fax_number": "608-441-2385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151714",
            "telephone_number": "608-443-5500",
            "fax_number": "608-263-6663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS COMMUNITY HEALTH CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2016-08-03",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "608-443-5518"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "WI",
            "license": "37-800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.