NPIMap

Organization Active NPI

Community Health and Immunization Services

Doing business as Chis

  • Community Health Worker
  • Providence, RI
National Provider Identifier
1972916229
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
MD12480 Issued in RI
Legal business name
COMMUNITY HEALTH AND IMMUNIZATION SERVICES
Doing business as
Chis
Practice address
100 Highland Ave
Suite 303
Providence, RI 02906-2753
Phone
(877) 358-3733
Fax
(877) 440-1795
NPI assigned
Jun 4, 2014
Last updated
Sep 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Authorized official

Name
Mr. Paul Fishburn
Title
Chief Operating Officer
Phone
(480) 646-9020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X MD12480 RI Primary

Addresses

Primary practice location

100 Highland Ave
Suite 303
Providence, RI 02906-2753

Mailing address

668 N 44TH St Ste 100W
Phoenix, AZ 85008-6507
Phone (877) 358-3733

Other names 1

  • CHIS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Health and Immunization Services LLC32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694736000000",
    "number": "1972916229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 N 44TH ST STE 100W",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850086507",
            "telephone_number": "877-358-3733",
            "fax_number": "877-440-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGHLAND AVE",
            "address_2": "SUITE 303",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062753",
            "telephone_number": "877-358-3733",
            "fax_number": "877-440-1795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH AND IMMUNIZATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-04",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A",
        "authorized_official_last_name": "FISHBURN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "480-646-9020",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "RI",
            "license": "MD12480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHIS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.