CHARTER OAK HEALTH CENTER, INC.
NPI 1003078734
Clinic/Center - Federally Qualified Health Center (FQHC) in Hartford, CT
About Charter Oak Health Center, Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CHARTER OAK HEALTH CENTER, INC. (NPI 1003078734) is a healthcare organization registered as a federally qualified health center (fqhc) in Hartford, Connecticut and active in the NPI registry since June 2008. The organization holds a CLIA Microscopy certificate valid through February 22, 2028 and lists Tim Powers, Chief Compliance Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate for Provider-Performed Microscopy Procedures (PPMP) 07D0094352
Charter Oak Health Center, Inc · Hartford, CTFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Charter Oak Health Center, Inc.'s NPI number?
The NPI number for Charter Oak Health Center, Inc. is 1003078734. It was assigned to this organization in the NPPES registry on June 25, 2008. The provider is also known as South Park Inn.
Where is Charter Oak Health Center, Inc. located?
Charter Oak Health Center, Inc. is located at 75 Main St, Hartford, CT 06106. The listed phone number is (860) 550-7500.
What is Charter Oak Health Center, Inc.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
Does Charter Oak Health Center, Inc. hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 07D0094352) is associated with this NPI, valid through February 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Charter Oak Health Center, Inc. was last updated on May 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Charter Oak Health Center, Inc. · NPI 1003078734
Federally Qualified Health Center (FQHC) organization in Hartford, Connecticut. Organization record, active in the CMS NPPES registry since June 25, 2008.
## Identity
- **NPI:** 1003078734 (Entity type: Organization)
- **Enumerated:** June 25, 2008
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Also known as:** South Park Inn (Other Name)
- **Organization subpart:** Yes (part of Charter Oak Health Center Inc.)
- **Authorized official:** Tim Powers, CHIEF COMPLIANCE OFFICER
## Practice location
- **Address:** 75 MAIN ST, Hartford, CT 06106-1806
- **Phone:** (860) 550-7500
## Record status
- **NPPES last updated:** May 8, 2026
- **Other identifiers:** Medicaid 004236007 (CT)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1003078734) · Data from the CMS NPPES public registry.