NPIMap

Organization Active NPI

City of Springfield

  • Community Health Clinic/Center
  • Springfield, MA
National Provider Identifier
1962531004
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
CITY OF SPRINGFIELD
Practice address
311 State Street
Springfield, MA 01105
Phone
(413) 787-6456
Fax
(413) 787-6458
NPI assigned
Mar 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Authorized official

Name
Helen Caulton-Harris
Title
Ceo/Director
Phone
(413) 787-6456

Specialties & licenses 1

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

Addresses

Primary practice location

311 State Street
Springfield, MA 01105

Mailing address

311 State Street
Springfield, MA 01105
Phone (413) 787-6456

Other identifiers 1

IdentifierTypeStateIssuer
1312227MedicaidMA

Other names 1

  • Springfield Dept. of Health & Human Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140819001847 MA Part A Provider - Federally Qualified Health Center (FQHC) 8921018540 Practice locations: Springfield, MA
O20180622000665 MA Part B Supplier - Clinic/Group Practice 8921018540 Receives reassigned benefits from 4 practitioners
Practice locations: Springfield, MA

Federally qualified health center certification: CCN 221926

Legal name
CITY OF SPRINGFIELD
Doing business as
HEALTH SERVICES FOR THE HOMELESS HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 2, 2014
Last certification
Sep 2, 2014
Ownership / control type
For profit – corporation
Organization structure
GovernmentNon-profit
Enrollment address
755 Worthington St
Springfield, MA 11051140

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
City of Springfield4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

755 Worthington St
Springfield, MA 01105
Phone (413) 337-9700

327 Liberty St
Springfield, MA 01104

775 Worthington St
Springfield, MA 01105
Phone (413) 734-7140

311 State St
Springfield, MA 01105
Phone (413) 733-5469

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Helen R Caulton Harris Individual W-2 Managing EmployeeExecutive Director Jan 1, 1996 100%
City of Springfield Organization, Springfield, MA Operational/Managerial Control Jan 4, 1984 100%
Tiana Marie Davis Individual W-2 Managing Employee Nov 17, 2019

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 4

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": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581379200000",
    "number": "1962531004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 STATE STREET",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "01105",
            "telephone_number": "413-787-6456",
            "fax_number": "413-787-6458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 STATE STREET",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "01105",
            "telephone_number": "413-787-6456",
            "fax_number": "413-787-6458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF SPRINGFIELD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A",
        "authorized_official_last_name": "CAULTON-HARRIS",
        "authorized_official_first_name": "HELEN",
        "authorized_official_title_or_position": "CEO/DIRECTOR",
        "authorized_official_telephone_number": "413-787-6456"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1312227",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Springfield Dept. of Health & Human Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Springfield Dept. of Health & Human Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.