NPIMap

Organization Active NPI

Central Texas Community Health Centers

Doing business as CommUnityCare

  • Federally Qualified Health Center (FQHC)
  • Austin, TX
National Provider Identifier
1114626090
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CENTRAL TEXAS COMMUNITY HEALTH CENTERS
Doing business as
CommUnityCare
Practice address
10701 S 1St St
Austin, TX 78748-3807
Phone
(512) 978-9811
NPI assigned
Feb 28, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Authorized official

Name
Joy Sloan, CPA
Title
Cfo
Phone
(512) 978-9811

Specialties & licenses 1

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

Addresses

Primary practice location

10701 S 1St St
Austin, TX 78748-3807

Mailing address

2115 Kramer LN
Austin, TX 78758-4195
Phone (502) 978-9811

Other names 1

  • CommUnityCare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230502001067 TX Part A Provider - Federally Qualified Health Center (FQHC) 5395802151 Practice locations: Austin, TX

Federally qualified health center certification: CCN 671071

Legal name
CENTRAL TEXAS COMMUNITY HEALTH CENTERS
Doing business as
COMMUNITYCARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 3, 2023
Last certification
Apr 3, 2023
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Nov 25, 2003 in TX
Enrollment address
10701 S 1St St
Austin, TX 78748-3807

National Provider Directory

National Provider Directory
Tax ID family
Central Texas Community14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Bradley Bryan Price Individual Corporate OfficerBoard Member Jun 28, 2022
Isaac Sanchez Individual Corporate OfficerBoard Member Sep 27, 2022
Jaeson T Fournier Individual Corporate OfficerPresident & Ceo Jun 5, 2017
W-2 Managing EmployeePresident & Ceo Jun 5, 2017
Sedora Jefferson Individual Corporate OfficerBoard Member Jan 25, 2023
Karen Siles Individual Corporate OfficerBoard Member Mar 25, 2017
Carlos Manuel Gormaz Individual Corporate OfficerBoard Member Nov 17, 2020
Guy Swenson Individual Corporate OfficerBoard Member Jan 22, 2019
Steven Hewitt Garrett Individual Corporate OfficerBoard Member Oct 26, 2021
Debra Kaye Locklear Individual Corporate OfficerBoard Member Apr 20, 2011
Thomas B Coopwood Individual Corporate OfficerBoard Member Jan 27, 2016
Barbara Ann Brooks-Shirley Individual Corporate OfficerBoard Member Jan 20, 2010
Joy Sloan Individual Corporate OfficerCfo May 19, 2019
W-2 Managing EmployeeCfo May 19, 2019
Kimberly Janeral Johnson Individual Corporate OfficerBoard Member Mar 23, 2021

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
CommunitycarePflugerville, TX, CCN 671083 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2023
CommunitycareAustin, TX, CCN 671103 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 15, 2023

NPI Registry JSON

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

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677542400000",
    "number": "1114626090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 KRAMER LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787584195",
            "telephone_number": "502-978-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 S 1ST ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787483807",
            "telephone_number": "512-978-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL TEXAS COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-28",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A",
        "authorized_official_last_name": "SLOAN",
        "authorized_official_first_name": "JOY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "512-978-9811",
        "authorized_official_credential": "CPA"
    },
    "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": "CommUnityCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.