NPIMap

Organization Active NPI

Christ Community Health Services Augusta, Inc.

  • Primary Care Clinic/Center
  • Augusta, GA
National Provider Identifier
1174716989
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CHRIST COMMUNITY HEALTH SERVICES AUGUSTA, INC.
Practice address
1226 Dantignac St
Augusta, GA 30901-2788
Phone
(706) 922-0600
Fax
(706) 922-0603
NPI assigned
Aug 24, 2007
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
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1226 Dantignac St
Augusta, GA 30901-2788

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
GPA951MedicaidSC
194208754AMedicaidGA

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
Practice locations: Augusta, GA

Other NPIs with the same Medicare PAC ID 4

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

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

Locations

1226 Dantignac St
Augusta, GA 30901
Phone (706) 922-0600

Ownership & related parties

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Christ Community Health Services Augusta, Inc.Augusta, GA, CCN 111953 Federally qualified health center Operational/Managerial Control Jul 1, 2007
Christ Community Health Services Augusta, Inc.Augusta, GA, CCN 111954 Federally qualified health center Operational/Managerial Control Jul 1, 2007
Christ Community Health Services Augusta, Inc.Augusta, GA, CCN 851168 Federally qualified health center Operational/Managerial Control (100%) Jul 1, 2007

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 34

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 34

NPI Registry JSON

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753660800000",
    "number": "1174716989",
    "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",
            "fax_number": "706-922-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 DANTIGNAC ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012788",
            "telephone_number": "706-922-0600",
            "fax_number": "706-922-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRIST COMMUNITY HEALTH SERVICES AUGUSTA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-24",
        "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": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GPA951",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194208754A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.