Community Health Development Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Uvalde, TX
NPI 1134102403 · NPPES record last updated Mar 26, 2024
Key facts
- NPI
- 1134102403
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- COMMUNITY HEALTH DEVELOPMENT INC.
- Practice address
- 200 Evans St
Uvalde, TX 78801-5142 - Phone
- (830) 278-7105
- Fax
- (830) 278-1836
- NPI assigned
- Nov 21, 2005
- Organization subpart
- No
Authorized official
- Name
- Mrs. Mayela Castanon
- Title
- Chief Executive Officer
- Phone
- (830) 278-5604
Owners & managing parties with NPI records 5
Owned or controlled facilities with NPI records 3
Other NPIs on the same Medicare enrollment 6
Other NPIs with the same Medicare PAC ID 5
Related certifications (CCN) 2
Practitioners 35
-
Jay Dale Akin, MD
-
Farrukh L Bhatti, MD
-
Somers Kindall Dean, LPC
-
Joana Lynn Hicks, FNP-C
-
Ethan Lopez, DO
-
Sarah Lopez, DO
-
Martha Medrano, M.D.
-
Mary Elizabeth Saenz, FNP-C
-
Katherine Belinda Smith, PA-C
-
David Aurelio Valdez, M.D.
-
Raza Ahmed Zia, DO
-
John Arthur Perez, P.A.
-
Rolando Perez, P.A.
-
Sandra Aguayo Castanon, P. A.
-
Rebecca Huizar Villa, LCSW
-
Isaac Martinez Saldivar, PH.D.
-
Patrice Anderson, LCSW
-
Marie Cristine Balais Bandala, FNP-BC, FNP-C
-
Sherryl O Dunlap, FNP-BC
-
Christopher A Farwell, ARNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in TX
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
- Corporation · Non-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
- Corporation · Non-profit
- Incorporated
- May 17, 1983 in TX
- Enrollment address
- 908 Evans St
Ste B
Uvalde, TX 78801-6052
All disclosed owners & managing parties 5
| Name | Role | Since | Share |
|---|---|---|---|
| Community Health Development, Inc. |
Other | May 1, 1983 | |
| 5% Or Greater Direct Ownership Interest | May 17, 1983 | 100% | |
| Brenda Sonora |
Corporate Director |
Apr 29, 2021 | |
| Christina Kelly |
W-2 Managing Employee |
May 10, 2021 | |
| W-2 Managing Employee |
May 10, 2021 | ||
| Mayela Castanon |
Corporate Director |
Aug 7, 2000 | |
| W-2 Managing Employee |
Dec 1, 2019 | ||
| Corporate Director |
Dec 1, 2019 | ||
| W-2 Managing Employee | Aug 7, 2000 | ||
| Delfina Diaz |
Corporate Director |
Apr 1, 2014 |
All facility ownership & control disclosures 3
| Facility | Type | Role | Since |
|---|---|---|---|
| Center for Community Wellness |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | May 17, 1983 |
| Chdi SBHC Uvalde |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | May 17, 1983 |
| Chdi Ham Lane |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | May 18, 1985 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
Locations
908 Evans St
Ste A
Uvalde, TX 78801
Phone 8302785604 ext. 3100
201 Evans St
Uvalde, TX 78801
908 Evans St
Bldg B
Uvalde, TX 78801
Phone (830) 278-3765
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00FM20 | Other | TX | MEDICARE TRAILBLAZER |
| 1851375224 | Other | TX | ROLAND PEREZ, PA |
| 1710110457 | Other | TX | AMBRISH PATEL, PA |
| 1871576868 | Other | TX | PROVIDER NPI |
| 111438102 | Medicaid | TX | |
| 1184685109 | Other | TX | JOHN PEREZ, PA |
Other names
- Our Health - Medical
Other providers in Uvalde, TX
- Clear Springs Center for Cancer Care LTD
- Clinical Partners, P.a.-Pain
- Carvel Key Collins
- Community Council of Southwest Texas, Inc.
- Community Council of Southwest Texas, Inc.
- Community Health Development Inc.
- Community Health Development Inc.
- Community Health Development, Inc
- Community Health Development, Inc.
- Community Health Development, Inc.
All providers in Uvalde, 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 26, 2024. 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.