Organization Active NPI

Community Health Centers of America

  • Federally Qualified Health Center (FQHC)
  • Mariposa, CA
National Provider Identifier
1891207684
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CENTERS OF AMERICA
Practice address
5320 Highway 49 N
Mariposa, CA 95338-9588
Phone
(209) 575-4575
Fax
(209) 575-4598
NPI assigned
Nov 2, 2017
Last updated
Jan 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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

Authorized official

Name
Jamie Dole
Title
Manager
Phone
(209) 575-4575

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A86330 CA
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

5320 Highway 49 N
Mariposa, CA 95338-9588

Mailing address

PO Box 3091
Modesto, CA 95353-3091
Phone (209) 575-4575

Other practice location 1

7085 N Maple Ave Ste 101
Fresno, CA 93720-8011
Phone (559) 431-8888

Other practice location 2

1300 N Fresno St Ste 220
Fresno, CA 93703-3843
Phone (559) 495-6707

Other practice location 3

101 N Front St
Chowchilla, CA 93610-2916
Phone (559) 201-9181

Other practice location 4

489 5th St
Gustine, CA 95322-1514
Phone (209) 854-3728

Other practice location 5

850 W Olive Ave
Merced, CA 95348-2427
Phone (209) 437-9410

Other practice location 6

104 W Alexander Ave
Merced, CA 95348-3410
Phone (209) 222-3979

Other practice location 7

517 Main St
Livingston, CA 95334-1427
Phone (209) 445-2388

Other practice location 8

6608 Mercy Ct Ste B
Fair Oaks, CA 95628-3171
Phone (916) 241-9844

Other practice location 9

2928 Eastern Ave
Sacramento, CA 95821-4210
Phone (916) 894-8212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA10 enrollments

Enrollment records 10

Enrollment IDStateProvider typePAC IDDetails
O20180213001169 CA Part B Supplier - Clinic/Group Practice 3476813460 Receives reassigned benefits from 179 practitioners
Practice locations: Sacramento, CA; Merced, CA; MC Farland, CA; Mariposa, CA; Gustine, CA; Livingston, CA; Chowchilla, CA; Fair Oaks, CA
O20210205002375 CA Part A Provider - Federally Qualified Health Center (FQHC) 3476813460 Practice locations: Mariposa, CA
O20211014003084 CA Part A Provider - Federally Qualified Health Center (FQHC) 3476813460 Practice locations: Livingston, CA
O20220223001534 CA Part A Provider - Federally Qualified Health Center (FQHC) 3476813460 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gustine, CA
O20230301002819 CA Part A Provider - Federally Qualified Health Center (FQHC) 3476813460 1 other NPI on this enrollment
Practice locations: MC Farland, CA
O20230505002433 CA Part A Provider - Federally Qualified Health Center (FQHC) 3476813460 Practice locations: Gustine, CA
O20230808002358 CA Part A Provider - Federally Qualified Health Center (FQHC) 3476813460 Practice locations: Fair Oaks, CA
O20230821002739 CA Part A Provider - Federally Qualified Health Center (FQHC) 3476813460 Practice locations: Sacramento, CA
O20231128000155 CA Part A Provider - Federally Qualified Health Center (FQHC) 3476813460 Practice locations: Chowchilla, CA
O20241122003914 CA Part A Provider - Federally Qualified Health Center (FQHC) 3476813460 Practice locations: Merced, CA

NPI to CCN mapping 9

The Medicare certification numbers (CCNs) connected to NPI 1891207684. Details of each certification follow.

Federally qualified health center certification: CCN 921905

Legal name
COMMUNITY HEALTH CENTERS OF AMERICA
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 31, 2020
Last certification
Dec 31, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 25, 2016 in CA
Enrollment address
5320 Highway 49 N
Ste 1
Mariposa, CA 95338-9588

Federally qualified health center certification: CCN A01029

Legal name
COMMUNITY HEALTH CENTERS OF AMERICA
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 20, 2021
Last certification
Sep 20, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 25, 2016 in CA
Enrollment address
517 Main St
Livingston, CA 95334-1427

Federally qualified health center certification: CCN A01072

Legal name
COMMUNITY HEALTH CENTERS OF AMERICA
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 16, 2022
Last certification
Mar 16, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 25, 2016 in CA
Enrollment address
554 5TH St
Gustine, CA 95322-1516

Federally qualified health center certification: CCN 051960

Legal name
COMMUNITY HEALTH CENTERS OF AMERICA
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 14, 2023
Last certification
Feb 14, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 25, 2016 in CA
Enrollment address
733 3Rd St
MC Farland, CA 93250-1008

Federally qualified health center certification: CCN 921097

Legal name
COMMUNITY HEALTH CENTERS OF AMERICA
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 29, 2023
Last certification
Mar 29, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 25, 2016 in CA
Enrollment address
489 5TH St
Gustine, CA 95322-1514

Federally qualified health center certification: CCN A01813

Legal name
COMMUNITY HEALTH CENTERS OF AMERICA
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 3, 2023
Last certification
Aug 3, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 25, 2016 in CA
Enrollment address
6608 Mercy CT
Fair Oaks, CA 95628-3170

Federally qualified health center certification: CCN A01194

Legal name
COMMUNITY HEALTH CENTERS OF AMERICA
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 18, 2023
Last certification
Aug 18, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 25, 2016 in CA
Enrollment address
2928 Eastern Ave
Sacramento, CA 95821-4210

Federally qualified health center certification: CCN A01819

Legal name
COMMUNITY HEALTH CENTERS OF AMERICA
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 27, 2023
Last certification
Nov 27, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 25, 2016 in CA
Enrollment address
101 N Front St
Chowchilla, CA 93610-2916

Federally qualified health center certification: CCN A01898

Legal name
COMMUNITY HEALTH CENTERS OF AMERICA
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 8, 2024
Last certification
Nov 8, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
850 W Olive Ave
Ste a
Merced, CA 95348-2427

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 2

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2191175Community Health Centers of America6608 Mercy Court Suite B, Fair Oaks, CA 95628Certificate of waiverAug 23, 2026
05D2296526Community Health Centers of America2928 Eastern Ave, Sacramento, CA 95821Certificate of waiverDec 28, 2027
05D2306508Community Health Centers of America489 5TH St, Gustine, CA 95322Certificate of waiverJun 18, 2028
05D2339332Community Health Centers of America7085 N Maple Ave, Suite 101, Fresno, CA 93720Certificate of waiverFeb 26, 2028

National Provider Directory

National Provider Directory

Locations

101 N Front St
Chowchilla, CA 93610
Phone (559) 201-9181

101 N Front St
Ste B
Chowchilla, CA 93610
Phone (559) 201-9181

160 S 13th St
Chowchilla, CA 93610
Phone (559) 665-0449

7085 N Maple Ave
Ste 101
Fresno, CA 93720
Phone (559) 431-8888

544 5TH Ave
Gustine, CA 95322

517 Main St
#A
Livingston, CA 95334
Phone (209) 445-2388

5320 State Highway 49 N
Mariposa, CA 95338
Phone (209) 233-1749

5320 State Highway 49 N
#13
Mariposa, CA 95338
Phone (209) 966-2344

5320 State Highway 49 N
Ste 13
Mariposa, CA 95338
Phone (209) 966-2344

5200 Pirrone Ct
Salida, CA 95368
Phone (209) 441-8383

5200 Pirrone Ct
Ste A
Salida, CA 95368

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
Shantaraju Policepatil Individual Corporate Director Apr 17, 2021
Corporate OfficerPresent Apr 17, 2021
Corporate DirectorPresident Apr 17, 2021
Corporate OfficerPresident Apr 17, 2021
Corporate Officer Apr 17, 2021
Gurdeep Singh Individual Corporate OfficerCoo Nov 15, 2017
W-2 Managing EmployeeCoo Nov 15, 2017
Operational/Managerial ControlCoo Nov 15, 2017
Corporate OfficerCoo and Ceo Nov 15, 2017
W-2 Managing EmployeeCoo-Ceo Nov 15, 2017
Operational/Managerial ControlCooand Ceo Nov 15, 2017
Corporate OfficerCoo-Ceo Nov 15, 2017
W-2 Managing EmployeeCoo-Ceo Nov 17, 2017
Operational/Managerial ControlCoo and Ceo Nov 15, 2017
Corporate OfficerCoo May 26, 2016
W-2 Managing EmployeeCoo May 26, 2016
W-2 Managing EmployeeCoo May 25, 2016
Corporate Officer May 26, 2016
W-2 Managing Employee May 25, 2016
Nandeesh Veerappa Individual Corporate OfficerCmo Aug 9, 2021
W-2 Managing EmployeeMD; Aug 9, 2021
Operational/Managerial ControlCmo Aug 9, 2021
Corporate OfficerCmo May 26, 2016
Corporate Officer May 26, 2016
Mrutyuniaya Hiremath Individual Corporate DirectorSecretary Mar 1, 2018
Corporate OfficerSecretary Mar 1, 2018
Corporate DirectorBoard Member Secretary Mar 1, 2018
Community Health Centers of America Organization, Salida, CA Corporation, Non-profit Operational/Managerial Control Jan 22, 2018 100%
Operational/Managerial Control May 26, 2016
Lodeman Baza Individual Corporate DirectorBoard Member Mar 1, 2018
Connie Collins Individual Corporate DirectorBoard Member Mar 1, 2018
Gail Joanne Pioski Individual Corporate DirectorBoard Member Mar 1, 2018
Sathyan Murugesan Individual Corporate Director Jan 20, 2024
Elizabeth Broomfield Individual Corporate Director Mar 20, 2021
Corporate DirectorBoard Member Mar 20, 2021
Daniel Kulibert Individual Corporate Director Jun 15, 2025
Hurbert Daniel Individual Corporate Director Jun 15, 2025
Corporate DirectorBoard Member Nov 27, 2021
Vinay Channaveerappa Individual Corporate OfficerCao Aug 1, 2022
W-2 Managing EmployeeAd; Aug 1, 2022
Naresh Channaveerappa Individual Corporate OfficerCeo-Cfo Jan 1, 2021
W-2 Managing EmployeeAd; Jan 1, 2021
Operational/Managerial ControlCeo-Cfo Jan 1, 2021
Corporate OfficerCeo-Cfo May 26, 2016
Corporate Officer May 26, 2016
Operational/Managerial ControlCeo_Cfo May 26, 2016
Luis Orellana Individual Corporate Director Mar 20, 2021
Corporate DirectorBoard Member Mar 20, 2021
Hawel Hawel Individual Corporate DirectorTreasurer Mar 1, 2018
Lori Kay Barrett Individual Corporate DirectorBoard Member Mar 1, 2018
Isabel Crutchfield Individual Corporate DirectorBoard Member Dec 1, 2019
Corporate DirectorBoard Member Mar 1, 2018
Corporate DirectorBoard Member Dec 15, 2019
Vinod Keremane Individual Corporate DirectorPresident Mar 1, 2018
Bryan Blew Individual Corporate DirectorVice President Mar 1, 2018
Rebecca Troy Individual Corporate DirectorBoard Member Nov 10, 2021
Corporate DirectorBoard Member Nov 27, 2021
Prashant Venkataiah Individual Corporate DirectorBoard Member Nov 1, 2021
Corporate DirectorBoard Member Apr 13, 2021
Corporate DirectorBoard Member Jul 1, 2023

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 183

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 183

NPI Registry JSON

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

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768953600000",
    "number": "1891207684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3091",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953533091",
            "telephone_number": "209-575-4575",
            "fax_number": "209-575-4575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 HIGHWAY 49 N",
            "city": "MARIPOSA",
            "state": "CA",
            "postal_code": "953389588",
            "telephone_number": "209-575-4575",
            "fax_number": "209-575-4598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7085 N Maple Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937208011",
            "country_code": "US",
            "telephone_number": "559-431-8888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 N Fresno St Ste 220",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937033843",
            "country_code": "US",
            "telephone_number": "559-495-6707",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 N Front St",
            "address_purpose": "LOCATION",
            "city": "Chowchilla",
            "state": "CA",
            "postal_code": "936102916",
            "country_code": "US",
            "telephone_number": "559-201-9181",
            "fax_number": "559-201-9395",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "489 5th St",
            "address_purpose": "LOCATION",
            "city": "Gustine",
            "state": "CA",
            "postal_code": "953221514",
            "country_code": "US",
            "telephone_number": "209-854-3728",
            "fax_number": "800-591-9213",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "850 W Olive Ave",
            "address_purpose": "LOCATION",
            "city": "Merced",
            "state": "CA",
            "postal_code": "953482427",
            "country_code": "US",
            "telephone_number": "209-437-9410",
            "fax_number": "559-220-9380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 W Alexander Ave",
            "address_purpose": "LOCATION",
            "city": "Merced",
            "state": "CA",
            "postal_code": "953483410",
            "country_code": "US",
            "telephone_number": "209-222-3979",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "517 Main St",
            "address_purpose": "LOCATION",
            "city": "Livingston",
            "state": "CA",
            "postal_code": "953341427",
            "country_code": "US",
            "telephone_number": "209-445-2388",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6608 Mercy Ct Ste B",
            "address_purpose": "LOCATION",
            "city": "Fair Oaks",
            "state": "CA",
            "postal_code": "956283171",
            "country_code": "US",
            "telephone_number": "916-241-9844",
            "fax_number": "916-241-9845",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2928 Eastern Ave",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958214210",
            "country_code": "US",
            "telephone_number": "916-894-8212",
            "fax_number": "916-244-8181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS OF AMERICA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-02",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A",
        "authorized_official_last_name": "DOLE",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "209-575-4575"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A86330",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mariposa, CA

Sources for this page

Verify at the official NPI Registry.