NPIMap

Organization Active NPI

Community Care Services Inc.

  • Community Based Hospice Care Agency
  • Dublin, TX
National Provider Identifier
1679510093
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
002671 Issued in TX
Legal business name
COMMUNITY CARE SERVICES INC.
Practice address
118 E Live Oak St
Dublin, TX 76446-1941
Phone
(254) 445-4675
Fax
(254) 445-2972
NPI assigned
Jun 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Authorized official

Name
Bobbie M Nichols
Title
V. President
Phone
(254) 445-2517

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 002671 TX Primary

Addresses

Primary practice location

118 E Live Oak St
Dublin, TX 76446-1941

Mailing address

118 E Live Oak St
Dublin, TX 76446-1941
Phone (254) 445-2517

Other identifiers 1

IdentifierTypeStateIssuer
000207700MedicaidTX

Other names 1

  • CCS Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120625000722 TX Part A Provider - Hospice 6608996343 Practice locations: Dublin, TX

Hospice certification: CCN 451594

Legal name
COMMUNITY CARE SERVICES INC.
Certification status
Active
Provider type (POS)
Hospice
Participating since
Feb 10, 1994
Last certification
Jun 10, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Nov 12, 1993 in TX
Enrollment address
118 E Live Oak St
Dublin, TX 76446-1914

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Community Care Services HospiceCCN 451594
Ownership
For-Profit
Certified
Feb 10, 1994
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2204537Community Care Services Hospice118 E Live Oak Suite 104, Dublin, TX 76446Certificate of waiverDec 8, 2026

National Provider Directory

National Provider Directory
Tax ID family
Community Care Services Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

109 S Patrick St
Dublin, TX 76446
Phone (254) 445-4150

207 S Bell St
Hamilton, TX 76531
Phone (254) 386-5556

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
Bobbie Nichols Individual 5% Or Greater Direct Ownership Interest Nov 12, 1993 50%
Corporate OfficerVice President/Secretary Nov 12, 1993
Operational/Managerial ControlVice President/Coo Nov 12, 1993 100%
Keith Nichols Individual 5% Or Greater Direct Ownership InterestPresident Nov 12, 1993 50%
Corporate OfficerPresident/Treasurer Nov 12, 1993

Practitioners & affiliated clinicians

Affiliated clinicians 9

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735257600000",
    "number": "1679510093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 E LIVE OAK ST",
            "city": "DUBLIN",
            "state": "TX",
            "postal_code": "764461941",
            "telephone_number": "254-445-2517",
            "fax_number": "254-445-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 E LIVE OAK ST",
            "city": "DUBLIN",
            "state": "TX",
            "postal_code": "764461941",
            "telephone_number": "254-445-4675",
            "fax_number": "254-445-2972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "BOBBIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "V. PRESIDENT",
        "authorized_official_telephone_number": "254-445-2517"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": "002671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000207700",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCS Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dublin, TX

Sources for this page

Verify at the official NPI Registry.