NPIMap

Organization Active NPI

Community Health Care

Doing business as Spanaway Middle School

  • Federally Qualified Health Center (FQHC)
  • Tacoma, WA
National Provider Identifier
1770329534
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CARE
Doing business as
Spanaway Middle School
Practice address
15701 B St E
Tacoma, WA 98445-1163
Phone
(253) 544-6534
NPI assigned
Jul 2, 2024
Last updated
Jul 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Authorized official

Name
David Flentge
Title
President & Ceo
Phone
(253) 722-1500

Specialties & licenses 1

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

Addresses

Primary practice location

15701 B St E
Tacoma, WA 98445-1163

Mailing address

1148 Broadway Ste 100
Tacoma, WA 98402-3518
Phone (253) 544-6534

Other names 1

  • Spanaway Middle School Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241106003860 WA Part A Provider - Federally Qualified Health Center (FQHC) 1850201559 Practice locations: Tacoma, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770329534. Details of each certification follow.

Federally qualified health center certification: CCN 501064

Legal name
COMMUNITY HEALTH CARE
Doing business as
COMMUNITY HEALTH CARE - SPANAWAY MIDDLE SCHOOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 14, 2025
Last certification
Feb 14, 2025
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Apr 24, 1987 in WA
Enrollment address
15701 B St E
Tacoma, WA 98445-1163

Other NPIs with the same Medicare PAC ID 12

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

National Provider Directory

National Provider Directory
Tax ID family
Community Healthcare34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

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

View all 33

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Alma Price Individual Corporate OfficerBoard Member Jan 1, 2021
Ken Repp Individual Corporate DirectorBoard Member Jan 1, 2021
Ladedria Griffin Stallworth Individual Corporate DirectorBoard Member Jan 1, 2021
David Flentge Individual Corporate OfficerPresident & Ceo Jan 19, 2011 100%
W-2 Managing EmployeePresident & Ceo Jan 19, 2011 100%
Katie Parker Individual Corporate DirectorBoard Chair Jan 1, 2024

NPI Registry JSON

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1770329534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1148 BROADWAY STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023518",
            "telephone_number": "253-544-6534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15701 B ST E",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984451163",
            "telephone_number": "253-544-6534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "FLENTGE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "253-722-1500"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spanaway Middle School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.