NPIMap

Organization Active NPI

El Centro del Barrio, Inc.

Doing business as Children's Shelter Clinic

  • Federally Qualified Health Center (FQHC)
  • San Antonio, TX
National Provider Identifier
1336213362
Registry record updated Jul 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
HBOCS00758-04-00 Issued in TX
Legal business name
EL CENTRO DEL BARRIO, INC.
Doing business as
Children's Shelter Clinic
Practice address
133 Cedar St
San Antonio, TX 78210-1119
Phone
(210) 227-8959
Fax
(210) 225-1553
NPI assigned
Nov 20, 2006
Last updated
Jul 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2009

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

Authorized official

Name
Chuck Walzel
Title
Cfo
Phone
(210) 334-3724

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X HBOCS00758-04-00 TX Primary

Addresses

Primary practice location

133 Cedar St
San Antonio, TX 78210-1119

Mailing address

3750 Commercial Ave
San Antonio, TX 78221-3117
Phone (210) 334-3700

Other identifiers 5

IdentifierTypeStateIssuer
120980102MedicaidTX
120980101MedicaidTX
120980105MedicaidTX
120980103MedicaidTX
00MT08OtherTXGROUP MEDICARE

Other names 1

  • Children's Shelter Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050304000037 TX Part A Provider - Federally Qualified Health Center (FQHC) 6800881285 Practice locations: San Antonio, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336213362. Details of each certification follow.

  • CCN 451874 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 451874

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CHILDREN'S SHELTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 1, 1993
Last certification
Jul 1, 1993
Ownership / control type
For profit – corporation
Facility address
133 Cedar St
San Antonio, TX 78210
Related CCNs
451831

Other NPIs with the same Medicare PAC ID 20

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

View all 20

National Provider Directory

National Provider Directory
Tax ID family
Centro del Barrio Inc37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

View all 36

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Centromed City Center ClinicSan Antonio, TX, CCN 451166 Federally qualified health center Operational/Managerial Control Jan 3, 2022

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247702400000",
    "number": "1336213362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 COMMERCIAL AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782213117",
            "telephone_number": "210-334-3700",
            "fax_number": "210-922-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 CEDAR ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782101119",
            "telephone_number": "210-227-8959",
            "fax_number": "210-225-1553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL CENTRO DEL BARRIO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2009-07-16",
        "status": "A",
        "authorized_official_last_name": "WALZEL",
        "authorized_official_first_name": "CHUCK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "210-334-3724"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "TX",
            "license": "HBOCS00758-04-00",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120980102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120980101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120980105",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120980103",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "00MT08",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Shelter Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.