NPIMap

Organization Active NPI

Community Health Development Inc.

Doing business as Our Health - Medical

  • Federally Qualified Health Center (FQHC)
  • Uvalde, TX
National Provider Identifier
1134102403
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH DEVELOPMENT INC.
Doing business as
Our Health - Medical
Practice address
200 Evans St
Uvalde, TX 78801-5142
Phone
(830) 278-7105
Fax
(830) 278-1836
NPI assigned
Nov 21, 2005
Last updated
Mar 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Authorized official

Name
Mrs. Mayela Castanon
Title
Chief Executive Officer
Phone
(830) 278-5604

Specialties & licenses 1

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

Addresses

Primary practice location

200 Evans St
Uvalde, TX 78801-5142

Mailing address

908 Evans St
Uvalde, TX 78801-6034
Phone (830) 278-5604

Other identifiers 6

IdentifierTypeStateIssuer
00FM20OtherTXMEDICARE TRAILBLAZER
1184685109OtherTXJOHN PEREZ, PA
1871576868OtherTXPROVIDER NPI
111438102MedicaidTX
1851375224OtherTXROLAND PEREZ, PA
1710110457OtherTXAMBRISH PATEL, PA

Other names 1

  • Our Health - Medical Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040317000564 TX Part B Supplier - Clinic/Group Practice 3072422740 Receives reassigned benefits from 20 practitioners
6 other NPIs on this enrollment
Practice locations: Campwood, TX; Leakey, TX; Uvalde, TX
O20070917000574 TX Part A Provider - Federally Qualified Health Center (FQHC) 3072422740 Practice locations: Uvalde, TX
O20191017001705 TX Part A Provider - Federally Qualified Health Center (FQHC) 3072422740 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Uvalde, TX

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1134102403. Details of each certification follow.

Federally qualified health center certification: CCN 451817

Legal name
COMMUNITY HEALTH DEVELOPMENT, INC.
Doing business as
OUR HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 17, 1983 in TX
Enrollment address
200 Evans St
Uvalde, TX 78801-5142

Federally qualified health center certification: CCN 451078

Legal name
COMMUNITY HEALTH DEVELOPMENT, INC.
Doing business as
CENTER FOR COMMUNITY WELLNESS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 14, 2019
Last certification
Oct 14, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 17, 1983 in TX
Enrollment address
908 Evans St
Ste B
Uvalde, TX 78801-6052

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory

Locations

115 Ham Ln
Uvalde, TX 78801
Phone (830) 278-7105

201 Evans St
Uvalde, TX 78801

908 Evans St
Bldg B
Uvalde, TX 78801
Phone (830) 278-3765

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Community Health Development, Inc. Organization, Uvalde, TX Corporation Other May 1, 1983
5% Or Greater Direct Ownership Interest May 17, 1983 100%
Brenda Sonora Individual Corporate DirectorBoard Member Apr 29, 2021
Christina Kelly Individual W-2 Managing EmployeeRevenue Cycle Manager May 10, 2021
W-2 Managing EmployeeBilling Manager May 10, 2021
Mayela Castanon Individual Corporate DirectorChief Executive Officer Aug 7, 2000
W-2 Managing EmployeeCeo Dec 1, 2019
Corporate DirectorChief Executive Officer Dec 1, 2019
W-2 Managing Employee Aug 7, 2000
Delfina Diaz Individual Corporate DirectorBoard Member Apr 1, 2014

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Center for Community WellnessUvalde, TX, CCN 451078 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 17, 1983
Chdi SBHC UvaldeUvalde, TX, CCN 971027 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 17, 1983
Chdi Ham LaneUvalde, TX, CCN 971082 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 18, 1985

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 35

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 35

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1134102403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 EVANS ST",
            "city": "UVALDE",
            "state": "TX",
            "postal_code": "788016034",
            "telephone_number": "830-278-5604",
            "fax_number": "830-278-1836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EVANS ST",
            "city": "UVALDE",
            "state": "TX",
            "postal_code": "788015142",
            "telephone_number": "830-278-7105",
            "fax_number": "830-278-1836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH DEVELOPMENT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-21",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "CASTANON",
        "authorized_official_first_name": "MAYELA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "830-278-5604",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE TRAILBLAZER",
            "identifier": "00FM20",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN PEREZ, PA",
            "identifier": "1184685109",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NPI",
            "identifier": "1871576868",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111438102",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROLAND PEREZ, PA",
            "identifier": "1851375224",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMBRISH PATEL, PA",
            "identifier": "1710110457",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Our Health - Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Uvalde, TX

Sources for this page

Verify at the official NPI Registry.