NPIMap

Organization Active NPI

Comprehensive Community Action, Inc

  • Community/Behavioral Health Agency
  • Cranston, RI
National Provider Identifier
1770849259
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
1502 Issued in RI
Legal business name
COMPREHENSIVE COMMUNITY ACTION, INC
Practice address
311 Doric Ave
Cranston, RI 02910-2903
Phone
(401) 467-9610
NPI assigned
Apr 9, 2012
Last updated
May 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Authorized official

Name
Kevin S Cote, CPA
Title
Finance Director
Phone
(401) 562-2250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 1502 RI Primary

Addresses

Primary practice location

311 Doric Ave
Cranston, RI 02910-2903

Mailing address

311 Doric Ave
Cranston, RI 02910-2903
Phone (401) 467-9610

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140610000839 RI Part A Provider - Federally Qualified Health Center (FQHC) 0749176055 Practice locations: Cranston, RI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770849259. Details of each certification follow.

Federally qualified health center certification: CCN 411840

Legal name
COMPREHENSIVE COMMUNITY ACTION, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 14, 2008
Last certification
Jul 14, 2008
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 7, 1967 in RI
Enrollment address
311 Doric Ave
Cranston, RI 29102903

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Comprehensive Community Action Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

1090 Cranston St
Cranston, RI 02920
Phone (401) 467-9610

30 Howard Ave
Cranston, RI 02920
Phone (401) 467-9610

848 Atwood Ave
Cranston, RI 02920

26 Hartford Pike
North Scituate, RI 02857
Phone (401) 647-2550

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Joanne M McGunagle Individual Corporate DirectorDirector Mar 8, 2004 100%
Marcia a Lopresti Individual Corporate OfficerBoard Member Jul 1, 2006 9%
John N Bucci Individual Corporate OfficerBoard Member Jul 1, 2001 9%
Jason P Bouchard Individual Corporate OfficerBoard Member Jul 1, 2008 9%
Marybeth Corrente Individual Corporate OfficerBoard Member Jul 1, 1996 9%
Marjorie C Barrett Individual Corporate OfficerBoard Member Jul 1, 2006 9%
Margaret M Long Individual Corporate OfficerBoard Member Jul 1, 2001 9%
Michelle P Davis Individual Corporate OfficerBoard Member Jul 1, 2011 9%
William E Walsh Individual Corporate DirectorDirector Feb 10, 2004 100%
W-2 Managing Employee Feb 10, 2004 100%

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": "1333929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1770849259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 DORIC AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029102903",
            "telephone_number": "401-467-9610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 DORIC AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029102903",
            "telephone_number": "401-467-9610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE COMMUNITY ACTION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-09",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "COTE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "401-562-2250",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "RI",
            "license": "1502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

Verify at the official NPI Registry.