NPIMap

Organization Active NPI

First Choice Health Centers, Inc.

Doing business as First Choice @ CHR Manchester

  • Federally Qualified Health Center (FQHC)
  • Manchester, CT
National Provider Identifier
1962884395
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
0816 Issued in CT
Legal business name
FIRST CHOICE HEALTH CENTERS, INC.
Doing business as
First Choice @ CHR Manchester
Practice address
444 Center St
3Rd Floor
Manchester, CT 06040-3926
Phone
(860) 610-6131
Fax
(860) 290-4142
NPI assigned
Jun 22, 2015
Last updated
Jan 31, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
FIRST CHOICE HEALTH CENTERS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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

Authorized official

Name
Eugene A Market, MPH
Title
Ceo
Phone
(860) 610-6131

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 0816 CT Primary

Addresses

Primary practice location

444 Center St
3Rd Floor
Manchester, CT 06040-3926

Mailing address

94 Connecticut Boulevard
East Hartford, CT 06108
Phone (860) 610-6131

Other identifiers 1

IdentifierTypeStateIssuer
004236164MedicaidCT

Other names 1

  • First Choice @ CHR Manchester Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060127000447 CT Part B Supplier - Clinic/Group Practice 2769417609 Receives reassigned benefits from 95 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Manchester, CT; Vernon, CT; East Hartford, CT
O20160222001607 CT Part A Provider - Federally Qualified Health Center (FQHC) 2769417609 Practice locations: Manchester, CT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962884395. Details of each certification follow.

Federally qualified health center certification: CCN 071918

Legal name
FIRST CHOICE HEALTH CENTERS INC
Certification status
Terminated Voluntary: merger or closure, Jun 8, 2018
Provider type (POS)
Federally qualified health center
Participating since
Mar 9, 2016
Last certification
Mar 9, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 19, 1995 in CT
Enrollment address
444 Center St
3Rd Floor
Manchester, CT 60403926

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 11

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

National Provider Directory

National Provider Directory
Tax ID family
First Choice Health Centers13 organizations share this tax ID, including this one
Part of
First Choice Health Centers

Other organizations with this tax ID 12

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

Locations

444 Center St
Fl 3
Manchester, CT 06040

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
David McKee Individual Corporate Director Feb 27, 2017
John C Connor Individual Corporate DirectorBoard Member Jul 1, 2009
Connor Duffy Individual Corporate Director Nov 28, 2022
Melissa Seville Individual Corporate Director Jul 23, 2019
Christopher Racuia Individual Corporate Director Nov 23, 2021
Winsome Barnaby Individual Corporate OfficerBoard Treasurer Jul 1, 2014
Corporate DirectorBoard Member Apr 1, 2014
Christopher Rucci Individual Corporate Director Jan 26, 2023
Ashoo Sharda Individual Corporate Director Jul 12, 2021
Annmarie Stevenson Individual Corporate OfficerBoard Secretary Oct 1, 2011
Corporate DirectorBoard Member Jul 1, 1995
Gislaine Ortiz-Jimenez Individual Corporate Director Feb 22, 2016
Jeffrey Steele Individual Corporate OfficerCeo Jun 20, 2017
Zafar Rashid Individual Corporate OfficerBoard Chair Jul 1, 2023
Corporate DirectorBoard Member Jul 1, 2015
Wanshenika Lewis Individual W-2 Managing EmployeeBilling Manager Mar 11, 2019
David J McQuade Individual Corporate DirectorBoard Member Mar 1, 2010
Sean Murphy Individual W-2 Managing EmployeeChief Financial Officer Jan 19, 2021

Practitioners & affiliated clinicians

Practitioners 5

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": "1434931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485820800000",
    "number": "1962884395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 CONNECTICUT BOULEVARD",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "06108",
            "telephone_number": "860-610-6131",
            "fax_number": "860-290-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 CENTER ST",
            "address_2": "3RD FLOOR",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060403926",
            "telephone_number": "860-610-6131",
            "fax_number": "860-290-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CHOICE HEALTH CENTERS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIRST CHOICE HEALTH CENTERS, INC.",
        "enumeration_date": "2015-06-22",
        "last_updated": "2017-01-31",
        "status": "A",
        "authorized_official_last_name": "MARKET",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "860-610-6131",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CT",
            "license": "0816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236164",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "First Choice @ CHR Manchester",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.