NPIMap

Organization Active NPI

Open Door Community Health Centers

Doing business as Open Door Downtown

  • Federally Qualified Health Center (FQHC)
  • Eureka, CA
National Provider Identifier
1831713452
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
OPEN DOOR COMMUNITY HEALTH CENTERS
Doing business as
Open Door Downtown
Practice address
622 H St
Eureka, CA 95501-1026
Phone
(707) 443-4666
NPI assigned
May 29, 2020
Last updated
Jun 7, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
OPEN DOOR COMMUNITY HEALTH CENTERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Authorized official

Name
Victor Starr
Title
President/Ceo
Phone
(707) 826-8633

Specialties & licenses 1

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

Addresses

Primary practice location

622 H St
Eureka, CA 95501-1026

Mailing address

1275 8TH St
Arcata, CA 95521-5770
Phone (707) 826-8633

Other names 1

  • Open Door Downtown Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040414000890 CA Part B Supplier - Clinic/Group Practice 9436067485 Receives reassigned benefits from 211 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Arcata, CA; Willow Creek, CA; McKinleyville, CA; Fortuna, CA; Ferndale, CA; Eureka, CA; Crescent City, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831713452. Details of each certification follow.

  • CCN 921874 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 921874

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
OPEN DOOR DOWNTOWN
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 18, 2020
Last certification
Aug 18, 2020
Ownership / control type
For profit – corporation
Facility address
622 H Street
Eureka, CA 95501

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Del Norte Community Hea

Locations

1275 8th St
Arcata, CA 95521

3770 Janes Rd
Arcata, CA 95521
Phone (707) 822-2404

3800 Janes Rd
#101
Arcata, CA 95521
Phone (707) 822-1385

770 10th St
Arcata, CA 95521
Phone (707) 826-8610

200 A St
Crescent City, CA 95531
Phone (707) 465-6925

2350 Buhne St
Ste A
Eureka, CA 95501
Phone (707) 443-4593

2412 Buhne St
Eureka, CA 95501
Phone (707) 441-1624

2426 Buhne St
Eureka, CA 95501
Phone (707) 442-4038

622 H St
Eureka, CA 95501
Phone (707) 443-4593

1644 Central Ave
Ste F
McKinleyville, CA 95519
Phone (707) 839-3068

670 9th St
Ste 203
McKinleyville, CA 95521

110 W First St
#B
Smith River, CA 95567
Phone (707) 487-0135

Practitioners & affiliated clinicians

Practitioners 258

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 258

NPI Registry JSON

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686096000000",
    "number": "1831713452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 8TH ST",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955215770",
            "telephone_number": "707-826-8633",
            "fax_number": "707-826-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 H ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011026",
            "telephone_number": "707-443-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN DOOR COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OPEN DOOR COMMUNITY HEALTH CENTERS",
        "enumeration_date": "2020-05-29",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A",
        "authorized_official_last_name": "STARR",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "707-826-8633"
    },
    "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": "Open Door Downtown",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Open Door Downtown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.