NPIMap

Organization Active NPI

Caring Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Hazle Township, PA
National Provider Identifier
1902459407
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CARING COMMUNITY HEALTH CENTER
Practice address
426 Airport Rd
Hazle Township, PA 18202-3361
Phone
(570) 459-9730
NPI assigned
Jul 23, 2019
Last updated
Jan 27, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Authorized official

Name
Matthew T Rogers
Title
President
Phone
(570) 271-6781

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

426 Airport Rd
Hazle Township, PA 18202-3361

Mailing address

660 Baltimore Dr Ste 125
Wilkes Barre, PA 18702-7962
Phone (570) 271-6781

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190830001893 PA Part B Supplier - Clinic/Group Practice 5698004588 Receives reassigned benefits from 115 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wilkes Barre, PA; Scranton, PA; Hazle Township, PA
O20210219000221 PA Part A Provider - Federally Qualified Health Center (FQHC) 5698004588 Practice locations: Hazle Township, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902459407. Details of each certification follow.

Federally qualified health center certification: CCN 391193

Legal name
CARING COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 16, 2021
Last certification
Feb 16, 2021
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Oct 1, 2019 in PA
Enrollment address
426 Airport Rd
Hazle Township, PA 18202-3361

Other NPIs with the same Medicare PAC ID 2

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.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Kathryn Hall Individual Corporate Officer Oct 1, 2019
Operational/Managerial Control Oct 1, 2019
David Bolton Individual Corporate Director Oct 1, 2019
Gabrielle M D Amico Individual Corporate Director Oct 1, 2019
Brenda H Hage Individual Corporate Director Oct 1, 2019
Daniel J Gaydon Individual Corporate Director Oct 1, 2019
Michael J Pendal Individual W-2 Managing Employee Oct 1, 2019
Ruth Abad Individual Corporate Director Oct 1, 2019

Practitioners & affiliated clinicians

Practitioners 40

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 40

NPI Registry JSON

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580083200000",
    "number": "1902459407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 BALTIMORE DR STE 125",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187027962",
            "telephone_number": "570-271-6781",
            "fax_number": "570-271-5947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 AIRPORT RD",
            "city": "HAZLE TOWNSHIP",
            "state": "PA",
            "postal_code": "182023361",
            "telephone_number": "570-459-9730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARING COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-23",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-271-6781"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "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 Hazle Township, PA

Sources for this page

Verify at the official NPI Registry.