NPIMap

Organization Active NPI

Valley Professionals Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Terre Haute, IN
National Provider Identifier
1962085449
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
VALLEY PROFESSIONALS COMMUNITY HEALTH CENTER INC
Practice address
4757 S 7TH St
Terre Haute, IN 47802-4559
Phone
(812) 234-2289
Fax
(812) 232-4234
NPI assigned
May 3, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Authorized official

Name
Terry J Warren
Title
Ceo
Phone
(765) 828-1003

Specialties & licenses 1

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

Addresses

Primary practice location

4757 S 7TH St
Terre Haute, IN 47802-4559

Mailing address

PO Box 344
Clinton, IN 47842-0344
Phone (765) 828-1003

Other names 1

  • VPCHC-SOUTH TERRE HAUTE Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071219000487 IN Part B Supplier - Clinic/Group Practice 7618067265 Receives reassigned benefits from 94 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West Terre Haute, IN; Terre Haute, IN; Rockville, IN; Clinton, IN; Crawfordsville, IN; Bloomingdale, IN; Cayuga, IN
O20210527000196 IN Part A Provider - Federally Qualified Health Center (FQHC) 7618067265 Practice locations: Terre Haute, IN

Federally qualified health center certification: CCN 151101

Legal name
VALLEY PROFESSIONALS COMMUNITY HEALTH CENTER INC
Doing business as
VPCHC-SOUTH TERRE HAUTE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 26, 2021
Last certification
May 26, 2021
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Enrollment address
4757 S 7TH St
Terre Haute, IN 47802-4559

Other NPIs with the same Medicare PAC ID 9

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

Other NPIs on the same Medicare enrollment 9

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
15D0695299Valley Professionals Community Health Center4757 S 7TH Street, Terre Haute, IN 47802Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Valley Professionals Community Health Center Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

703 W Park St
Cayuga, IN 47928
Phone (765) 492-9042

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Mary Helderman Individual Corporate Director Jul 1, 2021
Loretta Johnson Individual Corporate Director Jul 1, 2021
Jacqueline Mathis Individual Corporate Director Jan 1, 2024
David Allen Chapman Individual Corporate Director Jul 1, 2021
Terry J Warren Individual Corporate OfficerCeo Jul 1, 2021
W-2 Managing EmployeeCeo Jul 1, 2021
Michael Miller Individual Corporate Officer Jan 1, 2024
Kristin Craig Individual Corporate Director Jul 1, 2021
Mark Russell Individual Corporate Director Jul 1, 2021
Ronald Hodge Individual Corporate Director Jan 1, 2023
Marina Wolfe Individual Corporate Director Jan 1, 2023
John Michael Major Individual Corporate Director Jan 1, 2023
Danielle M Cundiff Individual Corporate Officer Sep 1, 2022
W-2 Managing Employee Sep 1, 2022
Louis Bonomo Individual Corporate Officer Mar 7, 2025
Jessica Marie Purcell Individual Corporate Director Jan 1, 2023
Jill Pastore Individual Corporate Director Jul 1, 2021
Christopher M Williams Individual Corporate Director Jan 1, 2023

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 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1962085449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 344",
            "city": "CLINTON",
            "state": "IN",
            "postal_code": "478420344",
            "telephone_number": "765-828-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4757 S 7TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478024559",
            "telephone_number": "812-234-2289",
            "fax_number": "812-232-4234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY PROFESSIONALS COMMUNITY HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-03",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "765-828-1003"
    },
    "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": "VPCHC-SOUTH TERRE HAUTE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.