NPIMap

Organization Active NPI

Health Care Center for the Homeless, Inc.

Doing business as Orange Blossom Family Health

  • Federally Qualified Health Center (FQHC)
  • Orlando, FL
National Provider Identifier
1952869968
Registry record updated Mar 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HEALTH CARE CENTER FOR THE HOMELESS, INC.
Doing business as
Orange Blossom Family Health
Practice address
4426 Old Winter Garden Rd
Orlando, FL 32811
Phone
(407) 428-5157
NPI assigned
Mar 8, 2019
Last updated
Mar 8, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
HEALTH CARE CENTER FOR THE HOMELESS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 8, 2019

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

Authorized official

Name
Dr. Chianta Shaw Lindsey, DNP, APRNNPI 1346360492
Title
Chief Operating Officer
Phone
(407) 428-5751

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

4426 Old Winter Garden Rd
Orlando, FL 32811

Mailing address

232 N Orange Blossom TRL
Orlando, FL 32805-1612
Phone (407) 428-5751

Other names 1

  • Orange Blossom Family Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101019001089 FL Part B Supplier - Clinic/Group Practice 6103895107 Receives reassigned benefits from 106 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kissimmee, FL; Orlando, FL
O20200219002138 FL Part A Provider - Federally Qualified Health Center (FQHC) 6103895107 Practice locations: Orlando, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1952869968. Details of each certification follow.

Federally qualified health center certification: CCN 681171

Legal name
HEALTH CARE CENTER FOR THE HOMELESS INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 19, 2020
Last certification
Feb 19, 2020
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Enrollment address
4426 Old Winter Garden Rd
Orlando, FL 32811-4211

Other NPIs with the same Medicare PAC ID 4

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
Tax ID family
Health Care Center for the14 organizations share this tax ID, including this one
Part of
Health Care Center for the

Other organizations with this tax ID 13

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

View all 13

Locations

2711 N Orange Blossom Trl
Ste A
Kissimmee, FL 34744

232 N Orange Blossom Trl
#2
Orlando, FL 32805

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
Jason Rimes Individual Corporate DirectorDirector Aug 5, 2010
Selena Williams Individual Corporate DirectorDirector Dec 31, 2010
Bakari Burns Individual Corporate DirectorPresident/Ceo Aug 5, 2010
W-2 Managing EmployeePresident/Ceo Aug 5, 2010
Cliff Morris Individual Corporate DirectorDirector Aug 5, 2010
Pierre Arsenec Individual Corporate DirectorDirector Dec 31, 2010
Chaney B Gordy Individual Corporate DirectorDirector Nov 5, 2004
Antonio Arias Individual Corporate DirectorDirector Aug 5, 2010

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 26

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 26

NPI Registry JSON

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

{
    "created_epoch": "1552003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552003200000",
    "number": "1952869968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 N ORANGE BLOSSOM TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328051612",
            "telephone_number": "407-428-5751",
            "fax_number": "407-428-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4426 OLD WINTER GARDEN RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32811",
            "telephone_number": "407-428-5157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH CARE CENTER FOR THE HOMELESS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTH CARE CENTER FOR THE HOMELESS, INC.",
        "enumeration_date": "2019-03-08",
        "last_updated": "2019-03-08",
        "status": "A",
        "authorized_official_last_name": "LINDSEY",
        "authorized_official_first_name": "CHIANTA",
        "authorized_official_middle_name": "SHAW",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "407-428-5751",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, APRN"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orange Blossom Family Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.