NPIMap

Organization Active NPI

Gulf Coast Health Center, Inc.

Doing business as Gulf Coast Health Center-Phillis Wheatley-SBHC

  • Federally Qualified Health Center (FQHC)
  • Port Arthur, TX
National Provider Identifier
1609596493
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GULF COAST HEALTH CENTER, INC.
Doing business as
Gulf Coast Health Center-Phillis Wheatley-SBHC
Practice address
1100 Jefferson Dr
Port Arthur, TX 77642-0638
Phone
(409) 983-1161
NPI assigned
Aug 31, 2022
Last updated
Sep 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Authorized official

Name
Marsha ThigpenNPI 1518047000
Title
Executive Director
Phone
(409) 983-1161

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1100 Jefferson Dr
Port Arthur, TX 77642-0638

Mailing address

2548 Memorial Blvd
Port Arthur, TX 77640-2825
Phone (409) 983-1161

Other names 1

  • Gulf Coast Health Center-Phillis Wheatley-SBHC Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lsolis@gulfcoasthc.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220930002783 TX Part A Provider - Federally Qualified Health Center (FQHC) 5597675215 Practice locations: Port Arthur, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609596493. Details of each certification follow.

Federally qualified health center certification: CCN 671028

Legal name
GULF COAST HEALTH CENTER INC
Doing business as
GULF COAST HEALTH CENTER-PHILLIS WHEATLEY-SBHC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 30, 2022
Last certification
Sep 30, 2022
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
May 18, 1989 in TX
Enrollment address
1100 Jefferson Dr
Port Arthur, TX 77642-0638

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
Gulf Coast Health Center Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

1100 Jefferson Dr
Port Arthur, TX 77642

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Phyllis Charles Individual Corporate Director Mar 1, 2009
Yadira Cardenas Individual Corporate Officer Jan 1, 2010
Sheila Norwood Individual Corporate Director Jan 1, 2010
Marsha E Thigpen Individual Corporate DirectorExecutive Director Jul 13, 2012
W-2 Managing Employee Jul 13, 2012

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 1

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

FacilityTypeRoleSince
Gulf Coast Health Center-Memorial High School SBHCPort Arthur, TX, CCN 971004 Federally qualified health center Other (100%) Aug 18, 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": "1661904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663545600000",
    "number": "1609596493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2548 MEMORIAL BLVD",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776402825",
            "telephone_number": "409-983-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 JEFFERSON DR",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776420638",
            "telephone_number": "409-983-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A",
        "authorized_official_last_name": "THIGPEN",
        "authorized_official_first_name": "MARSHA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "409-983-1161"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lsolis@gulfcoasthc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1100 Jefferson Dr",
            "city": "Port Arthur",
            "state": "TX",
            "country_code": "US",
            "postal_code": "776420638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Gulf Coast Health Center-Phillis Wheatley-SBHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Arthur, TX

Sources for this page

Verify at the official NPI Registry.