NPIMap

Organization Active NPI

Community Health & Emergency Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Carmi, IL
National Provider Identifier
1962632190
Registry record updated Jul 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH & EMERGENCY SERVICES, INC
Practice address
1400 W Main St
Carmi, IL 62821-1387
Phone
(618) 382-4181
Fax
(618) 392-3590
NPI assigned
Jul 22, 2009
Last updated
Jul 22, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2009

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

Authorized official

Name
Mr. Frederick L Bernstein
Title
Ceo
Phone
(618) 457-0450

Specialties & licenses 1

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

Addresses

Primary practice location

1400 W Main St
Carmi, IL 62821-1387

Mailing address

1400 W Main St
Carmi, IL 62821-1387
Phone (618) 382-4181

Other names 1

  • Carmi Community Health Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090818000519 IL Part A Provider - Federally Qualified Health Center (FQHC) 0749194702 Practice locations: Carmi, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962632190. Details of each certification follow.

Federally qualified health center certification: CCN 141104

Legal name
COMMUNITY HEALTH & EMERGENCY SERVICES INC
Doing business as
CARMI MEDICAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 1, 2009
Last certification
Sep 1, 2009
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 1, 1981 in IL
Enrollment address
1400 W Main St
Carmi, IL 62821-1387

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Tax ID family
Community Health Anesth18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Locations

1400 W Main St
Carmi, IL 62821
Phone (618) 382-4181

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
Kanci Houston Individual W-2 Managing Employee Oct 1, 2014
Katrina W Cerutti Individual Corporate OfficerBoard Member Nov 17, 2009
Joseph M Hancock Individual Corporate OfficerBoard Member Nov 28, 2000
Josie Eason Individual Corporate OfficerBoard Member Jul 31, 2007
Frederick L Bernstein Individual Corporate DirectorCeo Dec 1, 1989
Operational/Managerial ControlCeo Dec 1, 1989
Cordell McGoy Individual Corporate Officer Jan 30, 2014
Charles Soward Individual Corporate OfficerBoard Member Jul 22, 1996

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248220800000",
    "number": "1962632190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 W MAIN ST",
            "city": "CARMI",
            "state": "IL",
            "postal_code": "628211387",
            "telephone_number": "618-382-4181",
            "fax_number": "618-392-3590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W MAIN ST",
            "city": "CARMI",
            "state": "IL",
            "postal_code": "628211387",
            "telephone_number": "618-382-4181",
            "fax_number": "618-392-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH & EMERGENCY SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-22",
        "last_updated": "2009-07-22",
        "status": "A",
        "authorized_official_last_name": "BERNSTEIN",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "618-457-0450",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carmi Community Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Carmi, IL

Sources for this page

Verify at the official NPI Registry.