NPIMap

Organization Active NPI

Community Health Center of Cape Cod, Inc.

  • Federally Qualified Health Center (FQHC)
  • Mashpee, MA
National Provider Identifier
1730684275
Registry record updated Mar 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
4WAE Issued in MA
Legal business name
COMMUNITY HEALTH CENTER OF CAPE COD, INC.
Practice address
107 Commercial St
Mashpee, MA 02649-6507
Phone
(508) 477-7090
Fax
(508) 477-3090
NPI assigned
Mar 27, 2018
Last updated
Mar 27, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY HEALTH CENTER OF CAPE COD, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 27, 2018

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

Authorized official

Name
Michelle Lee Houlihan
Title
Excutive Assistant
Phone
(508) 477-7090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 4WAE MA Primary

Addresses

Primary practice location

107 Commercial St
Mashpee, MA 02649-6507

Mailing address

107 Commercial St
Mashpee, MA 02649-6507
Phone (508) 477-7090

Other practice location 1

1185 Falmouth Rd
Centerville, MA 02632-3066
Phone (508) 477-7090 ext. 1103

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200208000064 MA Part A Provider - Federally Qualified Health Center (FQHC) 4486699568 Practice locations: Centerville, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730684275. Details of each certification follow.

Federally qualified health center certification: CCN 221953

Legal name
COMMUNITY HEALTH CENTER OF CAPE COD, INC.
Doing business as
COMMUNITY HEALTH CENTER OF CAPE COD-CENTERVILLE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 15, 2020
Last certification
Feb 15, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 3, 1997 in MA
Enrollment address
1185 Falmouth Rd
Centerville, MA 26323066

Other NPIs with the same Medicare PAC ID 5

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D2158157Community Health Center of Cape Cod1185 Falmouth Rd, Centerville, MA 02632Provider-performed microscopyNov 20, 2026

National Provider Directory

National Provider Directory
Tax ID family
Community Health Center of Cape Cod Inc11 organizations share this tax ID, including this one
Part of
Community Health Center of Cape Cod Inc

Other organizations with this tax ID 10

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

Locations

1185 Falmouth Rd
Centerville, MA 02632
Phone (508) 862-9929

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
John Dawley Individual Corporate OfficerVice President Nov 1, 2024
Paul Smith Individual Corporate OfficerVice President Nov 1, 2017
Gina Hotton Individual Corporate Director Jan 31, 2011
Rudolph Hunter Individual Corporate OfficerTreasurer Nov 30, 2015
David Peterson Individual Corporate DirectorPresident of the Board Jan 1, 2010
Karen L Gardner Individual Corporate OfficerCeo Jan 1, 2000
Operational/Managerial Control Aug 1, 2007

NPI Registry JSON

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522108800000",
    "number": "1730684275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 COMMERCIAL ST",
            "city": "MASHPEE",
            "state": "MA",
            "postal_code": "026496507",
            "telephone_number": "508-477-7090",
            "fax_number": "508-477-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 COMMERCIAL ST",
            "city": "MASHPEE",
            "state": "MA",
            "postal_code": "026496507",
            "telephone_number": "508-477-7090",
            "fax_number": "508-477-3090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1185 Falmouth Rd",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "MA",
            "postal_code": "026323066",
            "country_code": "US",
            "telephone_number": "508-477-7090 x1103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTER OF CAPE COD, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HEALTH CENTER OF CAPE COD, INC.",
        "enumeration_date": "2018-03-27",
        "last_updated": "2018-03-27",
        "status": "A",
        "authorized_official_last_name": "HOULIHAN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "EXCUTIVE ASSISTANT",
        "authorized_official_telephone_number": "508-477-7090"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MA",
            "license": "4WAE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mashpee, MA

Sources for this page

Verify at the official NPI Registry.