Vista Community Clinic

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

080000002 Issued in CA

Legal business name

VISTA COMMUNITY CLINIC

Practice address

134 Grapevine Rd
Vista, CA 92083-4004

Phone

(760) 631-5030

NPI assigned

Aug 5, 2006

Last updated

May 1, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

VISTA COMMUNITY CLINICAs reported in NPPES

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

Authorized official

Name

Ms. Michele Lambert

Title

Cfo

Phone

(760) 726-0065

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851300123. Details of each certification follow.

• CCN 051944 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 051944

Legal name

VISTA COMMUNITY CLINIC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Feb 1, 1995

Last certification

Feb 1, 1995

Ownership / control type

For profit – partnership

Organization structure

CorporationNon-profit

Incorporated

Nov 11, 1972 in CA

Enrollment address

134 Grapevine Rd
Vista, CA 92083-4004

Other NPIs with the same Medicare PAC ID 4

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

• Vista Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Vista, CA
  • NPI 1295822658

  0042120156

  Same PAC ID
• Vista Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Oceanside, CA
  • NPI 1437245412

  0042120156

  Same PAC ID
• Vista Community Clinic

  • Federally Qualified Health Center (FQHC)
  • La Habra, CA
  • NPI 1497203541

  0042120156

  Same PAC ID
• Vista Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Oceanside, CA
  • NPI 1649363375

  0042120156

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

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

• Vista Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Vista, CA
  • NPI 1295822658

  O20031223000690

  Same enrollment

Part of

Vista Community Clinic - Dental

Locations

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.

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367366400000",
    "number": "1851300123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 VALE TERRACE DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920845218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 GRAPEVINE RD",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920834004",
            "telephone_number": "760-631-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA COMMUNITY CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VISTA COMMUNITY CLINIC",
        "enumeration_date": "2006-08-05",
        "last_updated": "2013-05-01",
        "status": "A",
        "authorized_official_last_name": "LAMBERT",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "760-726-0065",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "080000002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vista Community Clinic
• Vista Community Clinic
• Vista Community Clinic
• Vista Community Clinic
• Vista Community Clinic
• Vista Community Clinic
• Vista Community Clinic (Tri-City Branch Dispensary)
• Vista Community Clinic - Dental
• Vista Community Clinic - Family Medicine
• Vista Community Clinic - Pharmacy

• Federally Qualified Health Center (FQHC) in Vista, CA
• Providers in Vista, CA by specialty
• Federally Qualified Health Center (FQHC) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.