NPIMap

Organization Active NPI

Brazos Valley Community Action Agency, Inc

Doing business as HealthPoint

  • Federally Qualified Health Center (FQHC)
  • Trinity, TX
National Provider Identifier
1083194138
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC
Doing business as
HealthPoint
Practice address
315 Prospect Dr
Trinity, TX 75862-6202
Phone
(936) 744-1400
Fax
(936) 594-2418
NPI assigned
Aug 17, 2018
Last updated
Sep 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Authorized official

Name
Theresa Sabella
Title
Ceo
Phone
(979) 383-2348

Specialties & licenses 1

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

Addresses

Primary practice location

315 Prospect Dr
Trinity, TX 75862-6202

Mailing address

1500 University Dr E Ste 100
College Station, TX 77840-2600
Phone (979) 383-2340

Other names 1

  • HealthPoint Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040708001095 TX Part B Supplier - Clinic/Group Practice 4284542127 Receives reassigned benefits from 61 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Trinity, TX; Rockdale, TX; Navasota, TX; Madisonville, TX; Hempstead, TX; Hearne, TX; College Station, TX; Centerville, TX…
O20181203000208 TX Part A Provider - Federally Qualified Health Center (FQHC) 4284542127 Practice locations: Trinity, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083194138. Details of each certification follow.

Federally qualified health center certification: CCN 451024

Legal name
BRAZOS VALLEY COMMUNITY ACTION AGENCY INC
Doing business as
HEALTHPOINT
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 6, 2018
Last certification
Nov 6, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 17, 1972 in TX
Enrollment address
315 Prospect Dr
Trinity, TX 75862-6202

Other NPIs with the same Medicare PAC ID 14

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

View all 14

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Brazos Valley Community19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jennifer Mertz Individual Corporate OfficerChief Nursing Officer Jul 15, 2019 12%
Maryann Miyun Choi Individual Corporate OfficerChief Medical Officer Feb 5, 2024 12%
Mike Sutherland Individual Corporate DirectorBoard Member Aug 12, 2010
Debra Makowsky Individual Corporate OfficerChief Human Resources Officer Feb 1, 2024 12%
W-2 Managing EmployeeAd; Feb 1, 2024
William Rios Individual Corporate DirectorBoard Member Jun 1, 2021
Mathew Woods Individual Corporate DirectorBoard Member Jun 1, 2021
Jacqueln Morrow Individual Corporate DirectorBoard Member Jun 1, 2021
Janie O Velasquez Individual Corporate DirectorBoard Member Apr 11, 2014
James McCullough Individual Corporate DirectorBoard Member May 10, 2012
Tasha de la Torre Individual Corporate DirectorBoard Member Jun 1, 2024
Carolyn Konecny Individual Corporate OfficerChief Financial Officer Aug 19, 2024 15%
Kimberley Usher Individual Corporate DirectorBoard Member Sep 13, 2017
Brian Thurston Individual Corporate OfficerChief Information Officer Feb 1, 2024 12%
Lucina Monarrez Individual Corporate DirectorBoard Member Mar 18, 2026
Mary Wauters Individual Corporate OfficerChief Executive Officer Apr 4, 2022 12%
W-2 Managing Employee Apr 1, 2026
Laquita Clewis Individual Corporate DirectorBoard Member Sep 13, 2017
Yoexys Truxillo Individual Corporate OfficerInterim Chief Operations Officer May 4, 2026 12%

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 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726012800000",
    "number": "1083194138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 UNIVERSITY DR E STE 100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778402600",
            "telephone_number": "979-383-2340",
            "fax_number": "979-260-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 PROSPECT DR",
            "city": "TRINITY",
            "state": "TX",
            "postal_code": "758626202",
            "telephone_number": "936-744-1400",
            "fax_number": "936-594-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-17",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A",
        "authorized_official_last_name": "SABELLA",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "979-383-2348"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthPoint",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Trinity, TX

Sources for this page

Verify at the official NPI Registry.