NPIMap

Organization Active NPI

Oak Orchard Community Health Center, Inc.

  • Clinic/Center
  • Albion, NY
National Provider Identifier
1821633165
Registry record updated Nov 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
OAK ORCHARD COMMUNITY HEALTH CENTER, INC.
Practice address
317 West Ave
Albion, NY 14411-1522
Phone
(585) 589-5613
Fax
(585) 637-2375
NPI assigned
Nov 11, 2019
Last updated
Nov 11, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
OAK ORCHARD COMMUNITY HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 11, 2019

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

Authorized official

Name
Pamela A Keller
Title
Cio/Director Patient Accounts
Phone
(585) 637-3905

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU
Family Medicine Physician 207Q00000X NU
Massage Therapist 225700000X NU
Music Therapist 225A00000X NU
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

317 West Ave
Albion, NY 14411-1522

Mailing address

300 West Ave
Brockport, NY 14420-1118
Phone (585) 637-3905

Other names 1

  • The Wellness Center at Oak Orchard Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040521001124 NY Part B Supplier - Clinic/Group Practice 5496746927 Receives reassigned benefits from 61 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hornell, NY; Warsaw, NY; Medina, NY; Lyndonville, NY; Corfu, NY; Batavia, NY; Albion, NY; Alexander, NY…
O20200309002324 NY Part A Provider - Federally Qualified Health Center (FQHC) 5496746927 Practice locations: Albion, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821633165. Details of each certification follow.

Federally qualified health center certification: CCN 571197

Legal name
OAK ORCHARD COMMUNITY HEALTH CENTER, INC.
Doing business as
THE WELLNESS CENTER AT OAK ORCHARD
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 9, 2020
Last certification
Mar 9, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 21, 1973 in NY
Enrollment address
317 West Ave
Albion, NY 14411-1522

Other NPIs with the same Medicare PAC ID 10

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

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
Oak Orchard Community Health Center Inc

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

317 West Ave
Albion, NY 14411
Phone (585) 589-5613

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Chetna Chandrakala Individual Corporate OfficerCfo Jan 1, 2024
Danielle Renodin-Mead Individual W-2 Managing EmployeeMD; Jul 8, 2015
Sarah Sargent Individual W-2 Managing EmployeeController Nov 15, 2015
John Slenker Individual Corporate DirectorBoard Chair May 28, 2025

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Oak Orchard Community Health Center, Inc.Albion, NY, CCN 571832 Federally qualified health center Operational/Managerial Control Mar 9, 2022

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 5

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": "1573430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573430400000",
    "number": "1821633165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WEST AVE",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144201118",
            "telephone_number": "585-637-3905",
            "fax_number": "585-637-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 WEST AVE",
            "city": "ALBION",
            "state": "NY",
            "postal_code": "144111522",
            "telephone_number": "585-589-5613",
            "fax_number": "585-637-2375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK ORCHARD COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OAK ORCHARD COMMUNITY HEALTH CENTER, INC.",
        "enumeration_date": "2019-11-11",
        "last_updated": "2019-11-11",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CIO/DIRECTOR PATIENT ACCOUNTS",
        "authorized_official_telephone_number": "585-637-3905"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225A00000X",
            "taxonomy_group": "",
            "desc": "Music Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Wellness Center at Oak Orchard",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Albion, NY

Sources for this page

Verify at the official NPI Registry.