NPIMap

Central City Concern, Inc

Organization Active NPI Federally Qualified Health Center (FQHC) · Portland, OR

NPI 1831575679 · NPPES record last updated Apr 9, 2026

Key facts

NPI
1831575679
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
CENTRAL CITY CONCERN, INC
Practice address
2040 SE Powell Blvd
Portland, OR 97202-2345
Phone
(503) 226-4060
NPI assigned
Aug 4, 2015
Organization subpart
No

Authorized official

Name
Dr. Andrew Mendenhall, MD
Title
President & Ceo
Phone
(503) 294-1681

Owners & managing parties with NPI records 3

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

Other NPIs with the same Medicare PAC ID 11

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

Corporate family (same tax ID) 17

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OR

Federally qualified health center certification: CCN 381043

Legal name
CENTRAL CITY CONCERN, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 7, 2024
Last certification
Oct 7, 2024
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Sep 12, 1978 in OR
Enrollment address
2040 SE Powell Blvd
Portland, OR 97202-2345

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Jonathan Radmacher
Individual 		Corporate Officer
Board President		 Oct 20, 2010
Corporate Director
Board President		 Oct 20, 2010
Elisabeth Zeller
Individual 		Corporate Officer
Board Chair		 Feb 18, 2016
Corporate Director
Board Member		 Feb 18, 2016
Ann Remmers
Individual 		Corporate Director
Board Member		 Jan 15, 2025
David Swartley
Individual 		Corporate Director
Board Member		 Aug 18, 2021
Fernando Pena
Individual 		Corporate Officer
Board Secretary/Treasurer		 Apr 19, 2023
Corporate Director
Board Member		 Apr 19, 2023
Carrie Smith
Individual 		Corporate Director
Board Member		 Mar 15, 2023
Andrew B Mendenhall
Individual 		Corporate Officer
President & Ceo		 Jul 1, 2022
Corporate Director
President & Ceo		 Jul 1, 2022
W-2 Managing Employee
President & Ceo		 Jul 1, 2022
Operational/Managerial Control
President & Ceo		 Jul 1, 2022
Peter Beyer
Individual 		Corporate Officer
Chief Financial Officer		 Sep 7, 2021
W-2 Managing Employee
Chief Financial Officer		 Sep 7, 2021
Operational/Managerial Control
Chief Financial Officer		 Sep 7, 2021
Jenny Kim
Individual 		Corporate Director
Board Member		 Aug 20, 2025
Mamie Gathard
Individual 		Corporate Director
Board Member		 Sep 21, 2022
Katrina McPherson
Individual 		Corporate Director
Board Member		 Feb 17, 2023
David Chen
Individual 		Corporate Officer
General Counsel		 Jul 6, 2021
W-2 Managing Employee
General Counsel		 Jul 6, 2021
Operational/Managerial Control
General Counsel		 Jul 6, 2021
Phyusin Myint
Individual 		Corporate Director
Board Member		 Aug 20, 2025
William Rasmussen
Individual 		Corporate Director
Board Member		 Aug 20, 2025
Eric Fishman
Individual 		Corporate Director
Board Member		 May 18, 2022
Stacie L Carney
Individual 		Corporate Director
Board Member		 Oct 16, 2024
Rilla Delorier
Individual 		Corporate Officer
Board Vice Chair		 Nov 26, 2018
Corporate Director
Board Secretary/Treasurer		 Nov 26, 2018
Caresse Sakagawa
Individual 		Corporate Director
Board Member		 Sep 20, 2023
Marguerita Lightfoot
Individual 		Corporate Director
Board Member		 Nov 20, 2024

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20241007000730 OR Part a Provider - Federally Qualified Health Center (FQHC) 6103803259 Practice locations: Portland, OR

National Provider Directory

Tax ID family
Central City Concern Inc (18 organizations share this tax ID)

Specialties & licenses

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

Addresses

Primary practice location

2040 SE Powell Blvd
Portland, OR 97202-2345

Mailing address

121 NW Everett St
Portland, OR 97209-4049

Other names

  • Imani Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 9, 2026.

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775692800000",
    "number": "1831575679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 NW EVERETT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972094049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 SE POWELL BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972022345",
            "telephone_number": "503-226-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL CITY CONCERN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-04",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A",
        "authorized_official_last_name": "MENDENHALL",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "503-294-1681",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Imani",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Portland, OR

All providers in Portland, OR · Federally Qualified Health Center (FQHC) in Oregon

Sources for this page

Verify at the official NPI Registry.