NPIMap

Organization Active NPI

Charter Oak Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hartford, CT
National Provider Identifier
1841937679
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CHARTER OAK HEALTH CENTER, INC.
Practice address
175 Main St
Hartford, CT 06106-1818
Phone
(860) 550-7500
NPI assigned
May 13, 2022
Last updated
May 8, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CHARTER OAK HEALTH CENTER INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Authorized official

Name
Mr. Tim Powers
Title
Chief Compliance Officer
Phone
(860) 550-7500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

175 Main St
Hartford, CT 06106-1818

Mailing address

21 Grand St
Hartford, CT 06106-1541
Phone (860) 550-7500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221019001120 CT Part A Provider - Federally Qualified Health Center (FQHC) 3870401078 Practice locations: Hartford, CT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1841937679. Details of each certification follow.

Federally qualified health center certification: CCN 071969

Legal name
CHARTER OAK HEALTH CENTER, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 13, 2022
Last certification
Oct 13, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 22, 2002 in CT
Enrollment address
175 Main St
Hartford, CT 61061818

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Charter Oak Health Center6 organizations share this tax ID, including this one
Part of
Charter Oak Health Center

Other organizations with this tax ID 5

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

Locations

118 Main St
Hartford, CT 06106

27 Chestnut St
Hartford, CT 06120

32 Grand St
Hartford, CT 06106

34 Huyshope Ave
Hartford, CT 06106

401 New Britain Ave
Hartford, CT 06106
Phone (860) 241-0712

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Tim Powers Individual Corporate OfficerVP of Compliance Nov 1, 2018
Leslie Arroyo Individual Corporate DirectorBoard Member Jan 1, 2010
Martin John Individual Corporate DirectorTreasurer, Board Member Jul 25, 2012
Claudius McNish Individual Corporate DirectorBoard Member Jan 1, 2019
Ann Marie Patterson Individual Corporate OfficerChief Quality Officer Dec 13, 2005
Lolita Young Individual Corporate DirectorBoard Member Jan 1, 2019
Kathleen Hallahan Individual Corporate OfficerChief Financial Officer Aug 1, 2019
Andrew Bussey Individual Corporate OfficerChief Information Officer Dec 1, 2021
Adrian R Wood Individual Corporate DirectorChairperson, Board Member May 22, 2013
Anupama Voodarla Individual Corporate OfficerAssociate Chief Medical Officer Oct 1, 2021
Dana Coachman Individual Corporate OfficerVice President of Human Resources Jan 1, 2010
Joel Cruz Individual Corporate DirectorVice Chair, Board of Directors Apr 24, 2013
Nichelle a Mullins Individual Corporate OfficerPresident & Chief Executive Officer Oct 1, 2015 100%
Operational/Managerial ControlPresident & Chief Executive Officer Oct 1, 2015 100%

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 123

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 123

NPI Registry JSON

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

{
    "created_epoch": "1652400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778198400000",
    "number": "1841937679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 GRAND ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061061541",
            "telephone_number": "860-550-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 MAIN ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061061818",
            "telephone_number": "860-550-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARTER OAK HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHARTER OAK HEALTH CENTER INC.",
        "enumeration_date": "2022-05-13",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A",
        "authorized_official_last_name": "POWERS",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "860-550-7500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "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 Hartford, CT

Sources for this page

Verify at the official NPI Registry.