Community Health Programs
Organization Active NPI Community Health Clinic/Center · Lee, MA
NPI 1689945784 · NPPES record last updated Mar 30, 2023
Key facts
- NPI
- 1689945784
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Health Clinic/Center 261QC1500X
- License
- 4COJ (MA)
- Legal business name
- COMMUNITY HEALTH PROGRAMS
- Practice address
- CHP Lee Family Practice
11 Quarry Hill Road
Lee, MA 01238 - Phone
- (413) 243-0536
- Fax
- (413) 243-8040
- NPI assigned
- Jan 20, 2012
- Organization subpart
- No
Authorized official
- Name
- Karen Johnson
- Title
- Chief Human Resources and Complianc
- Phone
- (413) 528-9311
Other NPIs on the same Medicare enrollment 4
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 11
Practitioners 55
-
Erin D'Avella, PMHNP
-
Dana Betsy Gruber, PHD
-
Stephen A Alsdorf, M.D
-
Noah Ellis Barkley, FNP
-
Andrew W Beckwith, M.D
-
Terrance Alan Clarke, FNP
-
Antoine El Khoury, M.D.
-
Kathleen A Floyd, FNP BC
-
Alison M Flynn, ANP
-
Jonna I Gaberman, MD
-
Rebecca M Gamache, FNP
-
Claire A Horth, M.D
-
Mary Janell Hostetler, FNP-BC
-
Patricia Lehmann, MD
-
Giro Richard Samale, M.D.
-
Lara Setti, MD, MPH
-
Yi-Lo Yu, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MA
Federally qualified health center certification: CCN 221909
- Legal name
- COMMUNITY HEALTH PROGRAMS INC
- Doing business as
- CHP LEE FAMILY PRACTICE
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Feb 29, 2012
- Last certification
- Feb 29, 2012
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Nov 25, 1975 in MA
- Enrollment address
- 11 Quarry Hill Rd
Lee, MA 12389645
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Brian Drake |
Corporate Officer |
Jan 1, 2022 | 100% |
| Thomas Walbridge |
Corporate Director |
Jan 1, 2022 | 100% |
| Operational/Managerial Control |
Jan 1, 2022 | 100% | |
| Christopher Phillips |
Corporate Officer |
Dec 12, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041025000193 | MA | Part B Supplier - Clinic/Group Practice | 5799746608 |
Receives reassigned benefits from 104 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Adams, MA; Great Barrington, MA; Lee, MA; North Adams, MA; Pittsfield, MA |
| O20120223000398 | MA | Part a Provider - Federally Qualified Health Center (FQHC) | 5799746608 | Practice locations: Lee, MA |
National Provider Directory
- Tax ID family
- Community Health Programs
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Clinic/Center | 261QC1500X | 4COJ | MA | Yes |
Addresses
Primary practice location
CHP Lee Family Practice
11 Quarry Hill Road
Lee, MA 01238
Mailing address
P.O. Box 30
Great Barrington, MA 01230
Phone (413) 528-9311
Other names
- CHP Lee Family Practice
Other providers in Lee, MA
- Jean F. Clarke-Mitchell
- Terrance Alan Clarke
- Daniel Cohen
- Collaborative Endeavors, LLC
- Claudia Ann Colombari
- Thomas Consolati
- Robin Mary Coulehan
- Erin D'Avella
- Ajay R Desai
- Michael George Dominov
All providers in Lee, MA · Community Health Clinic/Center in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 30, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.