Central Texas Community Health Centers

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

CENTRAL TEXAS COMMUNITY HEALTH CENTERS

Practice address

1210 W. Braker Lane
Austin, TX 78758

Phone

(512) 978-9300

NPI assigned

Feb 3, 2012

Last updated

Aug 13, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

CENTRAL TEXAS COMMUNITY HEALTH CENTERSAs reported in NPPES

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

Authorized official

Name

Carolyn Konecny

Title

Cfo

Phone

(512) 978-9000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CommUnityCare - North Central Other name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720350978. Details of each certification follow.

• CCN 671982 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 671982

Legal name

CENTRAL TEXAS COMMUNITY HEALTH CENTERS

Doing business as

COMMUNITYCARE NORTH CENTRAL

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

May 25, 2012

Last certification

May 25, 2012

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Nov 25, 2003 in TX

Enrollment address

1210 W Braker LN
Austin, TX 78758-3801

Part of

Central Texas Community

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.

All facility ownership & control disclosures 2

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

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

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439424000000",
    "number": "1720350978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17366",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787607366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W. BRAKER LANE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78758",
            "telephone_number": "512-978-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL TEXAS COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL TEXAS COMMUNITY HEALTH CENTERS",
        "enumeration_date": "2012-02-03",
        "last_updated": "2015-08-13",
        "status": "A",
        "authorized_official_last_name": "KONECNY",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "512-978-9000"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2894107-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CommUnityCare - North Central",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Central Texas Community Health Centers
• Central Texas Community Health Centers (CommUnityCare)
• Central Texas Community Health Centers (CommUnityCare)
• Central Texas Community Health Centers (Chalmers Health Center)
• Central Texas Community Health Centers (CommUnityCare)
• Central Texas Community Health Centers (CommUnityCare)
• Central Texas Community Health Centers (CommUnityCare)
• Central Texas Community Health Centers (CommUnityCare Burleson COVID Testing Site)
• Central Texas Community Health Centers (CommUnityCare)
• Central Texas Community Health Centers

• Federally Qualified Health Center (FQHC) in Austin, TX
• Providers in Austin, TX by specialty
• Federally Qualified Health Center (FQHC) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.