NPIMap

Organization Active NPI

Spring Branch Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Houston, TX
National Provider Identifier
1669129375
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SPRING BRANCH COMMUNITY HEALTH CENTER
Practice address
902 Frostwood Dr Ste 108
Houston, TX 77024-2421
Phone
(713) 462-6565
NPI assigned
Mar 3, 2022
Last updated
Sep 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Authorized official

Name
Lori McCain, CFO
Title
Cfo
Phone
(713) 462-6565

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Community Health Worker 172V00000X

Addresses

Primary practice location

902 Frostwood Dr Ste 108
Houston, TX 77024-2421

Mailing address

5502 1St St
Katy, TX 77493-2472
Phone (713) 462-6565

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://emr.sbchc.net:443/mobiledoc/jsp/webemr/login.jsp Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040505001669 TX Part B Supplier - Clinic/Group Practice 3072501154 Receives reassigned benefits from 82 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cypress, TX; Katy, TX; Houston, TX
O20220510002711 TX Part A Provider - Federally Qualified Health Center (FQHC) 3072501154 Practice locations: Houston, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669129375. Details of each certification follow.

Federally qualified health center certification: CCN 451196

Legal name
SPRING BRANCH COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 28, 2022
Last certification
Mar 28, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 14, 2003 in TX
Enrollment address
902 Frostwood Dr
Ste 108
Houston, TX 77024-2421

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Spring Branch Community Health Center Organization, Houston, TX Non-profit Operational/Managerial Control Mar 1, 2006
Marlen J Trujillo Individual Corporate DirectorCeo Mar 1, 2006
W-2 Managing Employee Mar 1, 2006
Operational/Managerial Control Mar 1, 2006

Owners & managing parties with NPI records 8

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Spring Branch Community Health CenterKaty, TX, CCN 741861 Federally qualified health center 5% Or Greater Direct Ownership Interest Aug 18, 2014
Spring Branch Community Health CenterHouston, TX, CCN 741866 Federally qualified health center 5% Or Greater Direct Ownership Interest Aug 18, 2014
Spring Branch Community Health CenterHouston, TX, CCN 741965 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 1, 2016

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 7

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": "1646265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726012800000",
    "number": "1669129375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5502 1ST ST",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774932472",
            "telephone_number": "713-462-6565",
            "fax_number": "832-831-5369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 FROSTWOOD DR STE 108",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770242421",
            "telephone_number": "713-462-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRING BRANCH COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-03",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A",
        "authorized_official_last_name": "MCCAIN",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "713-462-6565",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "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": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://emr.sbchc.net:443/mobiledoc/jsp/webemr/login.jsp",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "902 Frostwood Dr Ste 108",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770242421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.