CHAMPION COMMUNITY PARTNERS, LLC
NPI 1922989144
Nurse Practitioner - Psychiatric/Mental Health in Massapequa Park, NY
About Champion Community Partners, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CHAMPION COMMUNITY PARTNERS, LLC (NPI 1922989144) is a healthcare organization registered as a psychiatric/mental health in Massapequa Park, New York and active in the NPI registry since September 2025. The organization lists Tracey Wallace, Vp Ops, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently 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 Champion Community Partners, LLC's NPI number?
The NPI number for Champion Community Partners, LLC is 1922989144. It was assigned to this organization in the NPPES registry on September 12, 2025.
Where is Champion Community Partners, LLC located?
Champion Community Partners, LLC is located at 5100 Sunrise Hwy, Massapequa Park, NY 11762. The listed phone number is (631) 696-4357.
What is Champion Community Partners, LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
When was this NPI record last updated?
The NPPES record for Champion Community Partners, LLC was last updated on September 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Champion Community Partners, Llc · NPI 1922989144
Psychiatric/Mental Health organization in Massapequa Park, New York. Organization record, active in the CMS NPPES registry since September 12, 2025.
## Identity
- **NPI:** 1922989144 (Entity type: Organization)
- **Enumerated:** September 12, 2025
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Tracey Wallace, VP OPS
## Practice location
- **Address:** 5100 SUNRISE HWY, Massapequa Park, NY 11762-2935
- **Phone:** (631) 696-4357
## Record status
- **NPPES last updated:** September 12, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1922989144) · Data from the CMS NPPES public registry.