CHARLOTTE COMMUNITY HEALTH CLINIC, INC. (NPI# 1902251275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902251275 |
| Entity Type | Organization |
| Organization Name | CHARLOTTE COMMUNITY HEALTH CLINIC, INC. |
| Practice Address |
5301 Wilkinson Blvd Charlotte NC 28208-5455 |
| Mailing Address |
8401 Medical Plaza Dr Ste 300 Charlotte NC 28262-8702 |
| Practice Telephone | 7043166561 |
| Practice Fax Number | 7043841977 |
| Mailing Telephone | 7043166561 |
| Mailing Fax Number | 7043841977 |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2020-10-08 |
| Authorized Official Name | CAROLYN C ALLISON (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 7043166561 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053801936 | Charlotte Community Health Clinic, Inc. | Clinic/Center | 1225 S Caldwell St, Charlotte, NC 28203-4556 | 2018-05-16 |
| 1528363868 | Charlotte Community Health Clinic, Inc. | Clinic/Center | 8401 Medical Plaza Dr Ste 300, Charlotte, NC 28262-8702 | 2011-01-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CHARLOTTE COMMUNITY HEALTH CLINIC, INC | 8401 Medical Plaza Dr Ste 300, Charlotte, NC 28262-8702 |
| Street Address |
5301 WILKINSON BLVD |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28208-5455 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083858690 | Patricia Louise Greer | Social Worker | 5301 Wilkinson Blvd, Charlotte, NC 28208-5455 | 2009-04-27 |
| 1023671070 | Jennifer Leigh Cook | Nurse Practitioner | 5301 Wilkinson Blvd, Charlotte, NC 28208-5455 | 2019-04-16 |
| 1215499520 | Charlotte Community Health Clinic Family Dentistry | Clinic/Center | 5301 Wilkinson Blvd, Charlotte, NC 28208-5455 | 2019-04-04 |
| 1073954590 | Kimberly Polonsky | Nurse Practitioner | 5301 Wilkinson Blvd, Charlotte, NC 28208-5455 | 2013-07-12 |
| 1386974400 | Elizabeth Bethel Alexander | Nurse Practitioner | 5301 Wilkinson Blvd, Charlotte, NC 28208-5455 | 2010-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124645544 | Charlotte Sp Senior Housing Opco, LLC | Custodial Care Facility | 6041 Piedmont Row Drive, Charlotte, NC 28208 | 2020-07-01 |
| 1750929659 | Tru Pearl Solution Services Pllc | Community/Behavioral Health | 2128 Remount Road Suite B, Charlotte, NC 28208 | 2019-12-11 |
| 1245880699 | Camilla A Raley | Technician | 1539 Walton Rd, Charlotte, NC 28208 | 2019-09-18 |
| 1912567041 | Nolan Scott Blake | In Home Supportive Care | 4926 Ridgeley Dr., Suite B, Charlotte, NC 28208 | 2019-06-20 |
| 1699244145 | Catalyst Chiropractic, Pllc | Chiropractor | 2620 Tuckaseegee Rd., Charlotte, NC 28208 | 2018-11-14 |
| 1255854691 | Jessica Lynne Hunter | Social Worker | 2011 Water Walk Lane Apt 209, Charlotte, NC 28208 | 2017-07-18 |
| 1700311420 | Matthew Christian Mundorf | Chiropractor | 2620 Tuckaseegee Rd, Charlotte, NC 28208 | 2017-05-01 |
| 1700235439 | Erin Merchant | Counselor | 2016 Millerton Avenue, #2213, Charlotte, NC 28208 | 2016-06-03 |
| 1528432564 | Monika Sheree Moore | Counselor | 3205 Freedom Dr, Charlotte, NC 28208 | 2015-11-13 |
| 1205224540 | Phadality Home Care | Home Health | 201 S Hoskins Rd., Suite 119, Charlotte, NC 28208 | 2015-01-08 |
| Find all providers in zip 28208 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558308080 | The C.w. Williams Community Health Center, Inc | Clinic/Center | 3333 Wilkinson Blvd, Charlotte, NC 28208-5631 | 2006-06-01 |
| 1912522020 | Gaston Family Health Services, Inc. | Clinic/Center | 6133 The Plz, Charlotte, NC 28215-2401 | 2020-06-15 |
| 1528363868 | Charlotte Community Health Clinic, Inc. | Clinic/Center | 8401 Medical Plaza Dr Ste 300, Charlotte, NC 28262-8702 | 2011-01-18 |
| 1447417670 | The C. W. Williams Community Health Center, Inc | Clinic/Center | 3333 Wilkinson Blvd, Charlotte, NC 28208-5631 | 2008-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831799667 | Bakersville Community Medical Clinic, Inc | Clinic/Center | 71 Blue Ridge Ln, Burnsville, NC 28714-7270 | 2020-10-30 |
| 1245842178 | Gaston Family Health Services, Inc. | Clinic/Center | 144 William Ellis Dr, Advance, NC 27006-7990 | 2020-08-21 |
| 1851909444 | Gaston Family Health Services, Inc. | Clinic/Center | 302 28th Ave Ne, Hickory, NC 28601-1116 | 2020-07-20 |
| 1750999496 | Gaston Family Health Services, Inc. | Clinic/Center | 180 War Eagle Dr, Mocksville, NC 27028-6151 | 2020-07-20 |
| 1518575265 | Gaston Family Health Services, Inc. | Clinic/Center | 4675 Oxford School Rd, Claremont, NC 28610-9468 | 2020-07-20 |
| 1124636873 | Gaston Family Health Services, Inc. | Clinic/Center | 451 Catawba Valley Blvd, Hickory, NC 28602-9631 | 2020-07-20 |
| 1093323099 | Gaston Family Health Services, Inc. | Clinic/Center | 5040 E Bandys Xrd, Catawba, NC 28609-8075 | 2020-07-16 |
| 1366088957 | Gaston Family Health Services, Inc. | Clinic/Center | 497 Farmington Rd, Mocksville, NC 27028-7639 | 2019-11-19 |
| 1285270868 | Gaston Family Health Services, Inc. | Clinic/Center | 160 Martin Luther King Junior Rd, Mocksville, NC 27028 | 2019-11-19 |
| 1306481957 | Gaston Family Health Services, Inc. | Clinic/Center | 3407 Plateau Rd, Newton, NC 28658-8809 | 2019-11-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.