NPIMap

Organization Active NPI

Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Tavares, FL
National Provider Identifier
1801284906
Registry record updated May 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CENTERS, INC
Practice address
212 E Main Street
Tavares, FL 32778-3808
Phone
(407) 905-8827
Fax
(407) 905-8998
NPI assigned
Dec 26, 2014
Last updated
May 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2015

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

Authorized official

Name
Margaret Brennan
Title
Ceo/President
Phone
(407) 905-8827

Specialties & licenses 1

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

Addresses

Primary practice location

212 E Main Street
Tavares, FL 32778-3808

Mailing address

110 S Woodland St
Winter Garden, FL 34787-3546
Phone (407) 905-8827

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161005002597 FL Part A Provider - Federally Qualified Health Center (FQHC) 4082515390 Practice locations: Tavares, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801284906. Details of each certification follow.

Federally qualified health center certification: CCN 681069

Legal name
COMMUNITY HEALTH CENTERS, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 26, 2016
Last certification
Oct 26, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1974 in FL
Enrollment address
212 E Main St
Tavares, FL 32778-3808

Other NPIs with the same Medicare PAC ID 14

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

View all 14

National Provider Directory

National Provider Directory
Tax ID family
WNTR GRDN Family37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

View all 36

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Nilmarie Zapata-Colon Individual Operational/Managerial Control2ND Vice Chairperson Aug 1, 2018 10%
Melissa Singh Individual Operational/Managerial Control1St Vice Chairperson Aug 1, 2016 10%
Mark W Dickinson Individual Corporate OfficerExec VP Cfo Mar 14, 2011
W-2 Managing EmployeeExec VP Cfo Mar 14, 2011
Debra Andree Individual Corporate OfficerChief Executive Officer Jan 12, 2020 10%
Community Health Centers, Inc Organization, Winter Garden, FL Corporation Operational/Managerial Control May 4, 2016 100%
Gisela Laurent Individual Operational/Managerial ControlDirector on Board Feb 1, 2018 10%
Darryl Owens Individual Operational/Managerial ControlDirector on Board Dec 1, 2024 10%
Kathy Rovito Individual Operational/Managerial ControlDirector on Board Jul 1, 2024 10%
Felicia Davis Individual Operational/Managerial ControlTreasurer on the Board Feb 1, 2021 10%
Dale Price Individual Operational/Managerial ControlDirector on Board May 1, 2018 10%
Jerry Kassab Individual Operational/Managerial ControlChairperson on Board Jun 1, 2017 10%
Timothy Walker Individual Operational/Managerial ControlSecretary of the Board May 1, 2015 10%

Owners & managing parties with NPI records 15

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 15

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Community Health Centers, IncOrlando, FL, CCN 681099 Federally qualified health center Operational/Managerial Control (100%) Apr 25, 2017
Community Health Centers, IncClermont, FL, CCN 681120 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Mar 19, 2018
Meadow Woods Health CenterOrlando, FL, CCN C11065 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 23, 2012

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1419552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432166400000",
    "number": "1801284906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S WOODLAND ST",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873546",
            "telephone_number": "407-905-8827",
            "fax_number": "407-905-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 E MAIN STREET",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327783808",
            "telephone_number": "407-905-8827",
            "fax_number": "407-905-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-26",
        "last_updated": "2015-05-21",
        "status": "A",
        "authorized_official_last_name": "BRENNAN",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "407-905-8827"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

Verify at the official NPI Registry.