NPIMap

Organization Active NPI

Vernon J Harris East End Community Health Center

Doing business as Capital Area Health Network - Greater Fulton Medical Center

  • Federally Qualified Health Center (FQHC)
  • Richmond, VA
National Provider Identifier
1760833008
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER
Doing business as
Capital Area Health Network - Greater Fulton Medical Center
Practice address
1718 Williamsburg Rd
Richmond, VA 23231-3428
Phone
(804) 780-0840
Fax
(804) 780-0862
NPI assigned
Jun 28, 2016
Last updated
Nov 17, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
VERNON J HARRIS EAST END COMMUNITY HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Authorized official

Name
Mr. Tracy Causey, MSPH, MBA
Title
Ceo
Phone
(804) 253-1968

Specialties & licenses 1

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

Addresses

Primary practice location

1718 Williamsburg Rd
Richmond, VA 23231-3428

Mailing address

2809 North Ave
Richmond, VA 23222-3647
Phone (804) 780-0840

Other names 2

  • Capital Area Health Network - Greater Fulton Medical Center Doing business as
  • GREATER FULTON MEDICAL CENTER Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040217000877 VA Part B Supplier - Clinic/Group Practice 9638064850 Receives reassigned benefits from 49 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: North Chesterfield, VA; Richmond, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1760833008. Details of each certification follow.

  • CCN 491949 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 491949

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 19, 2016
Last certification
Sep 19, 2016
Ownership / control type
For profit – corporation
Facility address
1718 Williamsburg Road
Richmond, VA 23231

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Part of
Vernon J Harris East En

Locations

1718 Williamsburg Rd
Richmond, VA 23231

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668643200000",
    "number": "1760833008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 NORTH AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232223647",
            "telephone_number": "804-780-0840",
            "fax_number": "804-329-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 WILLIAMSBURG RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232313428",
            "telephone_number": "804-780-0840",
            "fax_number": "804-780-0862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER",
        "enumeration_date": "2016-06-28",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A",
        "authorized_official_last_name": "CAUSEY",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "804-253-1968",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPH, MBA"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capital Area Health Network - Greater Fulton Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GREATER FULTON MEDICAL CENTER",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "GREATER FULTON MEDICAL CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.