NPIMap

Organization Active NPI

Community Clinic, Inc

  • Community/Retail Pharmacy
  • Gaithersburg, MD
National Provider Identifier
1851139232
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
COMMUNITY CLINIC, INC
Practice address
220 Girard St Ste 100
Gaithersburg, MD 20877-3467
Phone
(888) 792-8224
NPI assigned
Jul 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Authorized official

Name
Alisa Brightley
Title
Lead Credentialing Specialist
Phone
(240) 297-6758

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

220 Girard St Ste 100
Gaithersburg, MD 20877-3467

Mailing address

8665 Georgia Ave
Silver Spring, MD 20910-3405
Phone (301) 495-0318

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260121000303 DC Part B Supplier - Pharmacy 6204722614 1 other NPI on this enrollment
Practice locations: Gaithersburg, MD; Greenbelt, MD

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Community Clinic Inc13 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.

Ownership & related parties

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Cci Health ServicesTakoma Park, MD, CCN 211886 Federally qualified health center Operational/Managerial Control (100%) Apr 1, 2020
Community Clinic, IncGreenbelt, MD, CCN 211928 Federally qualified health center Other Dec 19, 2017

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725321600000",
    "number": "1851139232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8665 GEORGIA AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209103405",
            "telephone_number": "301-495-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 GIRARD ST STE 100",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208773467",
            "telephone_number": "888-792-8224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-18",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A",
        "authorized_official_last_name": "BRIGHTLEY",
        "authorized_official_first_name": "ALISA",
        "authorized_official_title_or_position": "LEAD CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "240-297-6758"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

Verify at the official NPI Registry.