NPIMap

Organization Active NPI

Vernon J Harris East End Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Richmond, VA
National Provider Identifier
1972636330
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER
Practice address
719 North 25TH Street
Richmond, VA 23223-6539
Phone
(804) 780-0840
Fax
(804) 780-0862
NPI assigned
Mar 14, 2007
Organization subpart
Yes
Parent organization
VERNON J HARRIS EAST END COMMUNITY HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Authorized official

Name
Tracy Causey
Title
Chief Executive Officer
Phone
(804) 253-1968

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

719 North 25TH Street
Richmond, VA 23223-6539

Mailing address

2809 North Ave
Richmond, VA 23222-3647
Phone (804) 780-0840

Other identifiers 1

IdentifierTypeStateIssuer
007602740MedicaidVA

Other names 1

  • Capital Area Health Network - Vernon J. Harris Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040217000877 VA Part B Supplier - Clinic/Group Practice 9638064850 Receives reassigned benefits from 49 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: North Chesterfield, VA; Richmond, VA
O20080708000659 VA Part A Provider - Federally Qualified Health Center (FQHC) 9638064850 Practice locations: Richmond, VA

Federally qualified health center certification: CCN 491841

Legal name
VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER
Doing business as
CAPITAL AREA HEALTH NETWORK - VERNON J HARRIS MEDICAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 28, 1999
Last certification
Jun 28, 1999
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Feb 15, 1998 in VA
Enrollment address
719 North 25TH Street
Richmond, VA 23223-6539

Other NPIs with the same Medicare PAC ID 6

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.

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
49D0959858Vernon J Harris Medical Center719 North 25TH Street, Richmond, VA 23223Provider-performed microscopyJul 27, 2027

National Provider Directory

National Provider Directory
Part of
Vernon J Harris East En

Locations

2740 Bensley Commons Blvd
#340B
North Chesterfield, VA 23237

2809 North Ave
#340B
Richmond, VA 23222

5855 Bremo Rd
Richmond, VA 23226
Phone (804) 287-7066

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Wilma Harris Individual Corporate Director Jul 1, 2012
Tracy Causey Individual Corporate OfficerChief Executive Officer Aug 1, 2006
W-2 Managing EmployeeChief Executive Officer Aug 1, 2006
Operational/Managerial ControlCeo Aug 1, 2006
Michelle Hall Individual Corporate Director Feb 1, 2013
Anna Ruth Staton Individual Corporate Director Jan 1, 2011

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668643200000",
    "number": "1972636330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 NORTH AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232223647",
            "telephone_number": "804-780-0840",
            "fax_number": "804-329-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 NORTH 25TH STREET",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232236539",
            "telephone_number": "804-780-0840",
            "fax_number": "804-780-0862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VERNON J HARRIS EAST END COMMUNITY HEALTH CENTER",
        "enumeration_date": "2007-03-14",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A",
        "authorized_official_last_name": "CAUSEY",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "804-253-1968"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007602740",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capital Area Health Network - Vernon J. Harris Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.