NPIMap

Organization Active NPI

Community Healthnet Inc

  • Community Health Clinic/Center
  • Gary, IN
National Provider Identifier
1952332298
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
COMMUNITY HEALTHNET INC
Practice address
1021 West 5TH Avenue
Gary, IN 46402-1703
Phone
(219) 880-1190
Fax
(219) 880-0784
NPI assigned
Jul 5, 2006
Last updated
Dec 21, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY HEALTHNET INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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

Authorized official

Name
Dr. Janet Seabrook, M.D.NPI 1043227507
Title
Executive Director
Phone
(219) 880-1190

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X
Community Health Clinic/Center 261QC1500X IN Primary

Addresses

Primary practice location

1021 West 5TH Avenue
Gary, IN 46402-1703

Mailing address

1021 West 5TH Avenue
Gary, IN 46402-1703
Phone (219) 880-1190

Other names 1

  • Gary Community Health Center Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060228000318 IN Part B Supplier - Clinic/Group Practice 6305852344 Receives reassigned benefits from 36 practitioners
7 other NPIs on this enrollment
Practice locations: Gary, IN; Hammond, IN; Merrillville, IN
O20060720000422 IN Part A Provider - Federally Qualified Health Center (FQHC) 6305852344 Practice locations: Gary, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1952332298. Details of each certification follow.

Federally qualified health center certification: CCN 151842

Legal name
COMMUNITY HEALTHNET INC
Doing business as
COMMUNITY HEALTHNET INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 14, 2006
Last certification
Sep 14, 2006
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 17, 1998 in IN
Enrollment address
1021 W 5TH Ave
Gary, IN 46402-1703

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Part of
Community Healthnet Inc

Locations

1015 N Shelby St
Gary, IN 46403
Phone (219) 938-0920

3900 Calhoun St
#R
Gary, IN 46408
Phone (219) 240-1851

5926 Calumet Ave
Hammond, IN 46320
Phone (219) 933-2442

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
Rise Ross-Ratney Individual Corporate Director Jul 7, 2006
Lynn Thomaolsezewski Individual Corporate DirectorBoard Member Nov 10, 2011
Glenda Dexter-Brown Individual Corporate Director Jul 7, 2006
Richard Hug Individual Corporate Director Jul 7, 2006
Don Bates Individual Corporate DirectorBoard Member Nov 1, 2011
Ramon Morton Individual Corporate Director Jul 7, 2006
Janet Seabrook Individual W-2 Managing EmployeeCeo Jun 1, 1997 100%

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Calumet High SchoolGary, IN, CCN 151905 Federally qualified health center Other Jun 17, 1998
Community Healthnet MerrillvilleMerrillville, IN, CCN 151903 Federally qualified health center Other Jun 17, 1998
Community Healthnet OscHammond, IN, CCN 151904 Federally qualified health center Other (100%) Jun 17, 1998
Community Healthnet MillerGary, IN, CCN 151908 Federally qualified health center Other Jun 17, 1998
Community Healthnet IncGary, IN, CCN 151068 Federally qualified health center Operational/Managerial Control (100%) Jun 17, 1998
Morton High SchoolHammond, IN, CCN 151179 Federally qualified health center Other Jun 17, 1998

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 37

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 37

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324425600000",
    "number": "1952332298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 WEST 5TH AVENUE",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464021703",
            "telephone_number": "219-880-1190",
            "fax_number": "219-880-0784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 WEST 5TH AVENUE",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464021703",
            "telephone_number": "219-880-1190",
            "fax_number": "219-880-0784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTHNET INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HEALTHNET INC",
        "enumeration_date": "2006-07-05",
        "last_updated": "2011-12-21",
        "status": "A",
        "authorized_official_last_name": "SEABROOK",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "219-880-1190",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gary Community Health Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Gary, IN

Sources for this page

Verify at the official NPI Registry.