NPIMap

Organization Active NPI

Community Health Care Systems, Inc

Doing business as Community Health Care Systems,Inc-Bibb

  • Clinic/Center
  • Macon, GA
National Provider Identifier
1659818623
Registry record updated Jan 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
COMMUNITY HEALTH CARE SYSTEMS, INC
Doing business as
Community Health Care Systems,Inc-Bibb
Practice address
250 Martin Luther King Jr Blvd
Macon, GA 31201-3490
Phone
(478) 864-3448
Fax
(478) 864-1288
NPI assigned
Jan 27, 2017
Last updated
Jan 27, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2017

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

Authorized official

Name
Carla W Belcher
Title
Ceo
Phone
(478) 552-7384

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

250 Martin Luther King Jr Blvd
Macon, GA 31201-3490

Mailing address

2251 W Elm St
Wrightsville, GA 31096-2017
Phone (478) 864-3448

Other names 1

  • COMMUNITY HEALTH CARE SYSTEMS,INC-BIBB Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040505000153 GA Part B Supplier - Clinic/Group Practice 5890783179 Receives reassigned benefits from 77 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wrightsville, GA; Wrens, GA; Warrenton, GA; Tennille, GA; Sparta, GA; Sandersville, GA; Milledgeville, GA; Macon, GA…
O20190802000152 GA Part A Provider - Federally Qualified Health Center (FQHC) 5890783179 Practice locations: Macon, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659818623. Details of each certification follow.

Federally qualified health center certification: CCN 111112

Legal name
COMMUNITY HEALTH CARE SYSTEMS, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 6, 2019
Last certification
Aug 6, 2019
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Sep 1, 1992 in GA
Enrollment address
250 Martin Luther King Jr Blvd
Ste 200
Macon, GA 31201-3490

Other NPIs with the same Medicare PAC ID 17

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

View all 17

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Community Health Care Systems Inc21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Kristie Brantely Individual Corporate OfficerBoard Member May 22, 2017 100%
Jeremy Kelley Individual Corporate OfficerBoard Member May 22, 2017 100%
Cathy Ivey Individual Corporate OfficerBoard Member May 22, 2017 100%
Michelle Stewart Individual Corporate OfficerBoard Member May 22, 2017 100%
David Montford Individual Corporate OfficerBoard Member May 22, 2017 100%
John Williams Individual Corporate OfficerBoard Member May 22, 2017 100%
Community Health Care Systems, Inc. Organization, Wrightsville, GA Corporation, Non-profit 5% Or Greater Direct Ownership Interest May 22, 2017 100%
Operational/Managerial Control May 22, 2017 100%
Jean Channell Individual Corporate OfficerBoard Member May 22, 2017 100%
Frank Smith Individual Corporate OfficerBoard Member May 22, 2017 100%
Pat Lyons Individual Corporate OfficerBoard Member May 22, 2017 100%
Mary Cook Individual Corporate OfficerBoard Member May 22, 2017 100%
Carla Belcher Individual Corporate DirectorCeo May 22, 2017 100%
W-2 Managing EmployeeCeo May 22, 2017 100%

Owners & managing parties with NPI records 17

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

View all 17

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Community Health Care Systems, Inc-BaldwinMilledgeville, GA, CCN 111022 Federally qualified health center Operational/Managerial Control Sep 1, 2015

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 3

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": "1485475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485475200000",
    "number": "1659818623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2251 W ELM ST",
            "city": "WRIGHTSVILLE",
            "state": "GA",
            "postal_code": "310962017",
            "telephone_number": "478-864-3448",
            "fax_number": "478-864-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MARTIN LUTHER KING JR BLVD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013490",
            "telephone_number": "478-864-3448",
            "fax_number": "478-864-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CARE SYSTEMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-27",
        "last_updated": "2017-01-27",
        "status": "A",
        "authorized_official_last_name": "BELCHER",
        "authorized_official_first_name": "CARLA",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "478-552-7384"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMMUNITY HEALTH CARE SYSTEMS,INC-BIBB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.