Community Action Committee of Pike Co..,Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

COMMUNITY ACTION COMMITTEE OF PIKE CO..,INC.

Practice address

7046 State Route 335
Beaver, OH 45613-9034

Phone

(740) 226-1924

NPI assigned

Mar 25, 2008

Last updated

Apr 2, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ray Roberts

Title

Executive Director

Phone

(740) 289-2371

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207094400000",
    "number": "1679745194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "941 MARKET ST",
            "city": "PIKETON",
            "state": "OH",
            "postal_code": "456619757",
            "telephone_number": "740-289-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7046 STATE ROUTE 335",
            "city": "BEAVER",
            "state": "OH",
            "postal_code": "456139034",
            "telephone_number": "740-226-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY ACTION COMMITTEE OF PIKE CO..,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-25",
        "last_updated": "2008-04-02",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "RAY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "740-289-2371"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0100134",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0989935",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika Lynn Boedeker, M.A.
• Brandi Renae Brinson, LPN
• Cecilia Renee Cantrell
• Curtis Allen Clark
• Katlyn Clark
• Christopher Conley
• Donna J Copley
• Olivia Cornwell
• Kristal Shay Dailey, CNP
• Bryce Lewis Dale

• Federally Qualified Health Center (FQHC) in Beaver, OH
• Providers in Beaver, OH by specialty
• Federally Qualified Health Center (FQHC) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.