Community Health Service Agency, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Commerce, TX
NPI 1104485374 · NPPES record last updated Mar 4, 2026
Key facts
- NPI
- 1104485374
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- COMMUNITY HEALTH SERVICE AGENCY, INC.
- Practice address
- 606 Culver St
Commerce, TX 75428-3608 - Phone
- (903) 259-3602
- NPI assigned
- Jun 11, 2019
- Organization subpart
- No
Authorized official
- Name
- Michelle P Carter
- Title
- Cfo
- Phone
- (903) 455-5986
Owners & managing parties with NPI records 1
-
Thomas J. Goss, DC
Other NPIs with the same Medicare PAC ID 6
Corporate family (same tax ID) 6
Practitioners 27
-
Elizabeth Bates, APRN, FNP-BC
-
Steven Thomas Beuke, APRN, FNP-C
-
Lisa Brittmon, APN, FNP-BC
-
Jessica Nicole Brooks, WHNP-BC
-
Kara Marie Cizdziel, M.D.
-
Keely Nicole Grant-Mirle, DNP, APRN, FNP-BC
-
Debra Lynn Grunden, NURSE
-
Benjamin Hanssen, FNP-C
-
Nehan Adil Khan, MD
-
Michelle Anne Lively, RNC, WHNP-BC, FNP-C
-
Kelly Lee Peters, FNP
-
Samantha Brooke Smith, DNP, APRN, FNP-C
-
Jennifer R Speulda, MSN, APRN, FNP-C
-
Emily Sundeen, FNP
-
Julie Tapiwa Thomison, FNP-BC
-
Kristi Whitenton, DO
-
Colt Wakefield Pickett, FNP-C, FNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Federally qualified health center certification: CCN 451069
- Legal name
- COMMUNITY HEALTH SERVICE AGENCY, INC.
- Doing business as
- CAREVIDE
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jul 19, 2019
- Last certification
- Jul 19, 2019
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Oct 15, 1976 in TX
- Enrollment address
- 606 Culver St
Commerce, TX 75428-3608
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Michelle Carter |
Corporate Officer |
Jan 1, 2013 | |
| Thomas J Goss |
Corporate Director |
Mar 31, 2015 | |
| Bryan Keith Winters |
Corporate Director |
Oct 1, 1970 | |
| Stan McKee |
Corporate Director |
Jan 1, 2002 | |
| Paul Kelley |
Corporate Director |
Apr 24, 2018 | |
| Wendi Alvarado |
W-2 Managing Employee |
May 18, 2009 | |
| Alma Paulin |
Corporate Director |
Jun 26, 2018 | |
| Nona Jordan |
Corporate Director |
Oct 1, 1997 | |
| Paul Painter |
Corporate Director |
Oct 1, 1997 | |
| Amy Wade |
Corporate Director |
Apr 25, 2017 | |
| James Andrew Bench |
Corporate Director |
Oct 1, 2013 | |
| Brenda Sue Cregg |
Corporate Director |
Jan 1, 2012 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190719000538 | TX | Part a Provider - Federally Qualified Health Center (FQHC) | 6305735150 | Practice locations: Commerce, TX |
National Provider Directory
- Tax ID family
- Community Health Servic
- Part of
- Community Health Servic
Locations
606 Culver St
Commerce, TX 75428
Phone (903) 259-3602
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
606 Culver St
Commerce, TX 75428-3608
Mailing address
PO Box 1908
Greenville, TX 75403-1908
Phone (903) 454-3025
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 402503301 | Medicaid | TX |
Other names
- Carevide
Other providers in Commerce, TX
- Britni D Clayton
- Comfort Smiles NRH PLLC
- Commerce Dental, PLLC
- Commerce Family Chiropractic PC
- Commerce Isd
- Elizabeth Corriere
- Robert Charles Cozart Jr.
- CVS Pharmacy Inc
- Clinton Dale Debord
- Suzette K. Doescher
All providers in Commerce, TX · Federally Qualified Health Center (FQHC) in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.