NPIMap

Organization Active NPI

Core Health Systems

  • Federally Qualified Health Center (FQHC)
  • Texarkana, TX
National Provider Identifier
1396427852
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CORE HEALTH SYSTEMS
Practice address
1911 Galleria Oaks Dr
Texarkana, TX 75503-4617
Phone
(903) 792-0212
Fax
(903) 792-0007
NPI assigned
Aug 3, 2023
Last updated
Feb 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Authorized official

Name
Rosemary O Villarreal, PESC
Title
Credentialing Specialist
Phone
(903) 234-4226

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X
General Practice Physician 208D00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X
Family Nurse Practitioner 363LF0000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X

Addresses

Primary practice location

1911 Galleria Oaks Dr
Texarkana, TX 75503-4617

Mailing address

107 Woodbine PL
Longview, TX 75601-2912
Phone (903) 758-2471

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230906003390 TX Part B Supplier - Clinic/Group Practice 9234599424 Receives reassigned benefits from 9 practitioners
Practice locations: Texarkana, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396427852. Details of each certification follow.

  • CCN 971058 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 971058

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
CORE HEALTH SYSTEMS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 14, 2025
Last certification
Mar 14, 2025
Ownership / control type
For profit – corporation
Facility address
1911 Galleria Oaks Dr
Texarkana, TX 75503

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1691020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740528000000",
    "number": "1396427852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 WOODBINE PL",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756012912",
            "telephone_number": "903-758-2471",
            "fax_number": "903-234-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 GALLERIA OAKS DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755034617",
            "telephone_number": "903-792-0212",
            "fax_number": "903-792-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE HEALTH SYSTEMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-03",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A",
        "authorized_official_last_name": "VILLARREAL",
        "authorized_official_first_name": "ROSEMARY",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "903-234-4226",
        "authorized_official_credential": "PESC"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "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": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.