NPIMap

Organization Active NPI

Community Health Centers of the Central Coast Inc

  • Clinic/Center
  • Arroyo Grande, CA
National Provider Identifier
1871010280
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC
Practice address
1205 E Grand Ave Ste H
Arroyo Grande, CA 93420-2419
Phone
(805) 994-2300
Fax
(805) 994-2395
NPI assigned
Aug 25, 2017
Last updated
Jan 23, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Authorized official

Name
Barbara A Allen
Title
Business Office Manager
Phone
(805) 361-8014

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1205 E Grand Ave Ste H
Arroyo Grande, CA 93420-2419

Mailing address

2050 S Blosser Rd
Santa Maria, CA 93458-7310
Phone (805) 361-8014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040115001161 CA Part B Supplier - Clinic/Group Practice 7416868120 Receives reassigned benefits from 236 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Santa Maria, CA; Paso Robles, CA; San Luis Obispo, CA; Templeton, CA; Oceano, CA; Arroyo Grande, CA; Atascadero, CA; Cambria, CA…
O20180509002732 CA Part A Provider - Federally Qualified Health Center (FQHC) 7416868120 Practice locations: Arroyo Grande, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1871010280. Details of each certification follow.

Federally qualified health center certification: CCN 921060

Legal name
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 1, 2018
Last certification
May 1, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 1, 1978 in CA
Enrollment address
1205 E Grand Ave
BLDG H
Arroyo Grande, CA 93420-2419

Other NPIs with the same Medicare PAC ID 22

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

View all 22

Other NPIs on the same Medicare enrollment 27

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

View all 27

National Provider Directory

National Provider Directory
Tax ID family
Comm HLTH CTRS CNTL CST22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Locations

1205 E Grand Ave
Ste H
Arroyo Grande, CA 93420
Phone (805) 361-8097

2050 S Blosser Rd
Santa Maria, CA 93458
Phone (805) 361-8014

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Sam Orozco Individual Corporate OfficerBoard Member Treasurer Mar 1, 2018 5%
Bertha Campos Individual Corporate OfficerBoard Member Mar 1, 2018 5%
Lue Thao Individual Corporate OfficerChief Financial Officer Feb 1, 2022 5%
W-2 Managing EmployeeChief Financial Officer Feb 1, 2022 5%
Ronald E Castle Individual Corporate OfficerChief Executive Officer Jul 1, 1978 10%
Barbara a Allen Individual W-2 Managing EmployeeBusiness Office Manager Mar 1, 2018 5%
William Gordon Individual Corporate OfficerBoard Member President Mar 1, 2018 5%

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548201600000",
    "number": "1871010280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 S BLOSSER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587310",
            "telephone_number": "805-361-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 E GRAND AVE STE H",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934202419",
            "telephone_number": "805-994-2300",
            "fax_number": "805-994-2395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-25",
        "last_updated": "2019-01-23",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "805-361-8014"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arroyo Grande, CA

Sources for this page

Verify at the official NPI Registry.