NPIMap

Organization Active NPI

First Choice Health Centers, Inc.

  • Dental Clinic/Center
  • Manchester, CT
National Provider Identifier
1811480403
Registry record updated Jun 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
FIRST CHOICE HEALTH CENTERS, INC.
Practice address
150 N Main St Ste 230
Manchester, CT 06042-2086
Phone
(860) 528-1359
Fax
(860) 528-5180
NPI assigned
Jun 8, 2018
Last updated
Jun 8, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2018

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

Authorized official

Name
Shannon Marie Gorneault
Title
Billing Manager
Phone
(860) 610-6124

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary
Federally Qualified Health Center (FQHC) 261QF0400X 0784 CT
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU

Addresses

Primary practice location

150 N Main St Ste 230
Manchester, CT 06042-2086

Mailing address

94 Connecticut Blvd
East Hartford, CT 06108-3013
Phone (860) 528-1359

Other identifiers 1

IdentifierTypeStateIssuer
004236164MedicaidCT

National Provider Directory

National Provider Directory
Tax ID family
First Choice Health Centers13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

150 N Main St
Ste 230
Manchester, CT 06042
Phone (860) 646-8117

Practitioners & affiliated clinicians

Practitioners 1

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": "1528416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528416000000",
    "number": "1811480403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 CONNECTICUT BLVD",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083013",
            "telephone_number": "860-528-1359",
            "fax_number": "860-528-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N MAIN ST STE 230",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060422086",
            "telephone_number": "860-528-1359",
            "fax_number": "860-528-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CHOICE HEALTH CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-08",
        "last_updated": "2018-06-08",
        "status": "A",
        "authorized_official_last_name": "GORNEAULT",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "860-610-6124"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CT",
            "license": "0784",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236164",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.