Middletown Community Health Center Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

MIDDLETOWN COMMUNITY HEALTH CENTER INC

Practice address

53 Gibson Road
Goshen, NY 10924

Phone

(845) 291-0348

Fax

(845) 343-5390

NPI assigned

Jun 13, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Theresa M Maloney

Title

Chief Executive Officer

Phone

(845) 343-7614

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Federally qualified health center certification: CCN 331126

Legal name

MIDDLETOWN COMMUNITY HEALTH CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Oct 14, 2014

Last certification

Oct 14, 2014

Ownership / control type

For profit – corporation

Facility address

53 Gibson Road
Goshen, NY 10924

Related CCNs

331898

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301011200000",
    "number": "1861696841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 987",
            "address_2": "21 ORCHARD STREET",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "10940",
            "telephone_number": "845-343-7614",
            "fax_number": "845-343-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 GIBSON ROAD",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "10924",
            "telephone_number": "845-291-0348",
            "fax_number": "845-343-5390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLETOWN COMMUNITY HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2011-03-25",
        "status": "A",
        "authorized_official_last_name": "MALONEY",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "845-343-7614",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00355931",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gail Messenger, LMHC
• Bridget Frances Meyer, RPH
• Ashley Miano, CASAC-T
• Michelle Angela Salvaggio
• Mid Hudson Orthopedic & Sports Medicine P.C.
• Kathleen Mary Miller, APRN, BC, PNP
• Linda S. Miller
• Kiran P Miner, LCSWR
• David Joseph Miranda, LCSW
• Thomas Mattingly Mirra, DPT

• Federally Qualified Health Center (FQHC) in Goshen, NY
• Providers in Goshen, NY by specialty
• Federally Qualified Health Center (FQHC) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2011; 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.