NPIMap

Organization Active NPI

Community Health Care, Inc.

Doing business as CHC-Adult Rehabilitation Center

  • Federally Qualified Health Center (FQHC)
  • Davenport, IA
National Provider Identifier
1700866605
Registry record updated Apr 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CARE, INC.
Doing business as
CHC-Adult Rehabilitation Center
Practice address
4001 N Brady St
Davenport, IA 52806-4003
Phone
(563) 336-3000
Fax
(563) 336-3044
NPI assigned
Jan 18, 2006
Last updated
Apr 29, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2013

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

Authorized official

Name
Thomas J Bowman
Title
Ceo
Phone
(563) 336-3000

Specialties & licenses 1

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

Addresses

Primary practice location

4001 N Brady St
Davenport, IA 52806-4003

Mailing address

500 W River Dr
Davenport, IA 52801-1014
Phone (563) 336-3000

Other identifiers 5

IdentifierTypeStateIssuer
13238OtherIAIA BC/BS GROUP#
8122859OtherILIL BC/BS GROUP#
113373OtherIAUNITED HEALTHCARE
CP8565OtherIARAIL ROAD MEDICARE GROUP
0080200MedicaidIA

Other names 1

  • CHC-Adult Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040317000776 IA Part B Supplier - Clinic/Group Practice 9830008895 Receives reassigned benefits from 78 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Davenport, IA; Muscatine, IA; Clinton, IA

Other NPIs on the same Medicare enrollment 11

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367193600000",
    "number": "1700866605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W RIVER DR",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528011014",
            "telephone_number": "563-336-3000",
            "fax_number": "563-336-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 N BRADY ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528064003",
            "telephone_number": "563-336-3000",
            "fax_number": "563-336-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-18",
        "last_updated": "2013-04-29",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "563-336-3000"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IA BC/BS GROUP#",
            "identifier": "13238",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL BC/BS GROUP#",
            "identifier": "8122859",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "113373",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE GROUP",
            "identifier": "CP8565",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0080200",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHC-Adult Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.