NPIMap

Organization Active NPI

Christ Community Health Services Augusta, Inc

  • Dental Clinic/Center
  • Augusta, GA
National Provider Identifier
1104630748
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
CHRIST COMMUNITY HEALTH SERVICES AUGUSTA, INC
Practice address
127 Telfair St Ste D
Augusta, GA 30901-2590
Phone
(706) 922-0601
Fax
(706) 849-4195
NPI assigned
Feb 4, 2025
Last updated
Jul 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Authorized official

Name
Ursula Shanerra Rosa
Title
Credentialing & Privileging Manager
Phone
(706) 922-0600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

127 Telfair St Ste D
Augusta, GA 30901-2590

Mailing address

PO Box 31164
Augusta, GA 30903-2964
Phone (706) 922-0600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080401000769 GA Part B Supplier - Clinic/Group Practice 6608953633 Receives reassigned benefits from 32 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Augusta, GA

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Christ Community Health Services Augusta Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

1238 Dantignac St
Augusta, GA 30901
Phone (706) 288-3081

124 Greene St
Augusta, GA 30901
Phone (706) 922-0600

127 Telfair St
Ste D
Augusta, GA 30901
Phone (706) 922-0600

Practitioners & affiliated clinicians

Practitioners 33

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.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1738627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753660800000",
    "number": "1104630748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31164",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309032964",
            "telephone_number": "706-922-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 TELFAIR ST STE D",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012590",
            "telephone_number": "706-922-0601",
            "fax_number": "706-849-4195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRIST COMMUNITY HEALTH SERVICES AUGUSTA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-04",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A",
        "authorized_official_last_name": "ROSA",
        "authorized_official_first_name": "URSULA",
        "authorized_official_middle_name": "SHANERRA",
        "authorized_official_title_or_position": "CREDENTIALING & PRIVILEGING MANAGER",
        "authorized_official_telephone_number": "706-922-0600"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.