JACKMAN COMMUNITY HEALTH CENTER
NPI 1669802849
Clinic/Center - Federally Qualified Health Center (FQHC) in Jackman, ME
About Jackman Community Health Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACKMAN COMMUNITY HEALTH CENTER (NPI 1669802849) is a healthcare organization registered as a federally qualified health center (fqhc) in Jackman, Maine and active in the NPI registry since November 2013. The organization holds a CLIA Waiver certificate valid through December 4, 2026 and lists Lori L. Dwyer, President & Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jackman Community Health Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
144Medicare enrollment records show 144 clinicians reassign Medicare billing to Jackman Community Health Center, which bills Medicare for the services they deliver. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 13
Nearest to this location (20)
See all 144Bangor, ME 04401
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 of Waiver 20D0709006
Jackman Community Health Center · Jackman, MEFrequently 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 Penobscot Community Health Center's NPI number?
The NPI number for Penobscot Community Health Center is 1669802849. It was assigned to this organization in the NPPES registry on November 25, 2013. The provider is doing business as Jackman Community Health Center.
Where is Penobscot Community Health Center located?
Penobscot Community Health Center is located at 376 Main St, Jackman, ME 04945. The listed phone number is (207) 668-4300.
What is Penobscot Community Health Center's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
Is Penobscot Community Health Center enrolled in Medicare?
Yes. Penobscot Community Health Center is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Penobscot Community Health Center?
According to the CMS Revalidation Reassignment List (October 2026 release), 144 clinicians in 13 Medicare specialties reassign their Medicare billing to Penobscot Community Health Center. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (68), Clinical Social Worker (27) and Family Practice (14). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Penobscot Community Health Center hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 20D0709006) is associated with this NPI, valid through December 4, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Penobscot Community Health Center was last updated on August 6, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.
# Jackman Community Health Center · NPI 1669802849
Federally Qualified Health Center (FQHC) organization in Jackman, Maine. Organization record, active in the CMS NPPES registry since November 25, 2013.
## Identity
- **NPI:** 1669802849 (Entity type: Organization)
- **Enumerated:** November 25, 2013
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Legal business name:** Penobscot Community Health Center
- **Organization subpart:** Yes (part of Penobscot Community Health Center)
- **Authorized official:** Lori Dwyer, PRESIDENT & CEO
## Practice location
- **Address:** 376 MAIN ST, Jackman, ME 04945
- **Phone:** (207) 668-4300 · **Fax:** (207) 668-7605
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 144 clinicians in 13 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (68), Clinical Social Worker (27), Family Practice (14); [full list](https://npiprofile.com/npi/1669802849/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 6, 2018
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1669802849) · Data from the CMS NPPES public registry.