NPIMap

Organization Active NPI

Amistad Community Health Center Incorporated

Doing business as Amistad Health

  • Federally Qualified Health Center (FQHC)
  • Aransas Pass, TX
National Provider Identifier
1346056546
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
AMISTAD COMMUNITY HEALTH CENTER INCORPORATED
Doing business as
Amistad Health
Practice address
1711 W Wheeler Ave Ste 3
Aransas Pass, TX 78336-4565
Phone
(361) 884-2242
Fax
(361) 884-2243
NPI assigned
Dec 4, 2024
Last updated
Apr 3, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
AMISTAD COMMUNITY HEALTH CENTER INCORPORATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Authorized official

Name
Mrs. Tamiko Rochell Richardson
Title
Revenue Cycle and Compliance Coord
Phone
(903) 736-2577

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

1711 W Wheeler Ave Ste 3
Aransas Pass, TX 78336-4565

Mailing address

1533 S Brownlee Blvd
Corpus Christi, TX 78404-3131
Phone (361) 884-2242

Other names 1

  • Amistad Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250917000976 TX Part A Provider - Federally Qualified Health Center (FQHC) 8527131036 Practice locations: Aransas Pass, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346056546. Details of each certification follow.

Federally qualified health center certification: CCN 971074

Legal name
AMISTAD COMMUNITY HEALTH CENTER INCORPORATED
Doing business as
AMISTAD HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 28, 2025
Last certification
Jul 28, 2025
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Enrollment address
1711 W Wheeler Ave
Ste 3
Aransas Pass, TX 78336-4565

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Tax ID family
Amistad Comm HLTH Ctr Inc8 organizations share this tax ID, including this one
Part of
Amistad Comm HLTH Ctr Inc

Other organizations with this tax ID 7

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

Locations

1533 S Brownlee Blvd
#100
Corpus Christi, TX 78404
Phone (361) 884-2242

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
Susanne Wood Individual OtherBoard Member Jul 1, 2023
Steven Leon Gates Individual OtherBoard Member Feb 1, 2019
Pamela Brower Individual OtherBoard Member Aug 1, 2023
Christine Nicosia Individual OtherBoard Member Nov 1, 2023
Esther Jones Individual OtherBoard Member Feb 1, 2019
Tamiko Richardson Individual W-2 Managing EmployeeRevenue and Compliance Coordinator Aug 1, 2024
OtherDelegated Official Aug 1, 2024
Suzelle Tinnell Individual OtherBoard Member Jan 1, 2021
Mark Meyer Individual OtherBoard Member Feb 1, 2018
Alfred Martinez Individual OtherBoard Member Aug 1, 2024
Diana Rivers Individual OtherBoard Member Aug 1, 2019
Eric Baggerman Individual Corporate OfficerCeo Jan 29, 2024
W-2 Managing Employee Sep 1, 2024
Nicholas L Adame Individual OtherBoard Member Aug 1, 2018
Angela Leal Individual OtherBoar Member Dec 1, 2021

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Rcm360 LLCRobstown, TX, CCN 451103 Federally qualified health center Operational/Managerial Control Jan 1, 2020
Amistad Community Health Center IncorporatedAransas Pass, TX, CCN 451164 Federally qualified health center Operational/Managerial Control Nov 1, 2021

Owned or controlled facilities with NPI records 2

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": "1733270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743638400000",
    "number": "1346056546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1533 S BROWNLEE BLVD",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784043131",
            "telephone_number": "361-884-2242",
            "fax_number": "361-884-2243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 W WHEELER AVE STE 3",
            "city": "ARANSAS PASS",
            "state": "TX",
            "postal_code": "783364565",
            "telephone_number": "361-884-2242",
            "fax_number": "361-884-2243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMISTAD COMMUNITY HEALTH CENTER INCORPORATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMISTAD COMMUNITY HEALTH CENTER INCORPORATED",
        "enumeration_date": "2024-12-04",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "TAMIKO",
        "authorized_official_middle_name": "ROCHELL",
        "authorized_official_title_or_position": "REVENUE CYCLE AND COMPLIANCE COORD",
        "authorized_official_telephone_number": "903-736-2577",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amistad Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Amistad Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aransas Pass, TX

Sources for this page

Verify at the official NPI Registry.