NPIMap

Organization Active NPI

Community Health Net

  • Federally Qualified Health Center (FQHC)
  • Girard, PA
National Provider Identifier
1992185458
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH NET
Practice address
1135 Lake St Ste 2
Girard, PA 16417-1063
Phone
(814) 455-7222
Fax
(814) 459-6678
NPI assigned
May 31, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Authorized official

Name
Craig A Ulmer
Title
Ceo
Phone
(814) 454-4530

Specialties & licenses 1

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

Addresses

Primary practice location

1135 Lake St Ste 2
Girard, PA 16417-1063

Mailing address

PO Box 369
Erie, PA 16512-0369
Phone (814) 454-4530

Other identifiers 1

IdentifierTypeStateIssuer
1007543070054MedicaidPA

Other names 1

  • Girard School-Based Health Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031222000617 PA Part B Supplier - Clinic/Group Practice 1759290588 Receives reassigned benefits from 29 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Harborcreek, PA; Erie, PA; Girard, PA
O20160304000870 PA Part A Provider - Federally Qualified Health Center (FQHC) 1759290588 Practice locations: Girard, PA

Federally qualified health center certification: CCN 391070

Legal name
COMMUNITY HEALTH NET
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 16, 2015
Last certification
Dec 16, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 30, 1985 in PA
Enrollment address
1135 Lake St
Ste 2
Girard, PA 16417-1049

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 5

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
39D2109573Girard School Based Health Center1135 Lake Street, Girard, PA 16417Certificate of waiverFeb 28, 2028

National Provider Directory

National Provider Directory
Tax ID family
Community Health Net6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

4401 Iroquois Ave
Erie, PA 16511
Phone (814) 455-7222

1135 Lake St
Girard, PA 16417
Phone (814) 774-3155

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
Phil Cardella Individual Corporate OfficerChief Financial Officer Feb 1, 2022
Craig Ulmer Individual Corporate OfficerCeo Apr 10, 2017
W-2 Managing EmployeeCeo Apr 10, 2017
Operational/Managerial ControlCeo Apr 10, 2017
Linda Pinnell Individual W-2 Managing EmployeeCompliance Analyst Jan 11, 2019
Anthony R Ignocheck Individual Corporate DirectorMedical Director Oct 1, 2015

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 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1433030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682035200000",
    "number": "1992185458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 369",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165120369",
            "telephone_number": "814-454-4530",
            "fax_number": "814-456-2375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 LAKE ST STE 2",
            "city": "GIRARD",
            "state": "PA",
            "postal_code": "164171063",
            "telephone_number": "814-455-7222",
            "fax_number": "814-459-6678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH NET",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-31",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A",
        "authorized_official_last_name": "ULMER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "814-454-4530"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007543070054",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Girard School-Based Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Girard, PA

Sources for this page

Verify at the official NPI Registry.