NPIMap

Organization Active NPI

Community Health Service Agency, Inc.

Doing business as Carevide

  • Federally Qualified Health Center (FQHC)
  • Greenville, TX
National Provider Identifier
1821475575
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH SERVICE AGENCY, INC.
Doing business as
Carevide
Pediatric Center of Greenville
Practice address
3005 Joe Ramsey Blvd E Ste a
Greenville, TX 75401-7776
Phone
(903) 455-4458
Fax
(903) 455-1604
NPI assigned
May 1, 2015
Last updated
Mar 4, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Authorized official

Name
Michelle P Carter
Title
Cfo
Phone
(903) 455-5986

Specialties & licenses 1

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

Addresses

Primary practice location

3005 Joe Ramsey Blvd E Ste a
Greenville, TX 75401-7776

Mailing address

PO Box 1908
Greenville, TX 75403-1908
Phone (903) 454-3025

Other identifiers 1

IdentifierTypeStateIssuer
368577801MedicaidTX

Other names 2

  • Carevide Doing business as
  • Pediatric Center of Greenville Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150709001924 TX Part A Provider - Federally Qualified Health Center (FQHC) 6305735150 Practice locations: Greenville, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821475575. Details of each certification follow.

Federally qualified health center certification: CCN 741898

Legal name
COMMUNITY HEALTH SERVICE AGENCY, INC.
Doing business as
CAREVIDE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 9, 2015
Last certification
Jul 9, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 15, 1976 in TX
Enrollment address
3005 Joe Ramsey Blvd E
Ste a
Greenville, TX 75401-7776

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Tax ID family
Comm HLTH SVC Agency Inc7 organizations share this tax ID, including this one
Part of
Comm HLTH SVC Agency Inc

Other organizations with this tax ID 6

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

Locations

3005 Joe Ramsey Blvd E
Ste A
Greenville, TX 75401
Phone (903) 454-1886

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
Michelle Carter Individual Corporate OfficerChief Excutive Officer Jan 1, 2013
Thomas J Goss Individual Corporate DirectorBoard Vice Chair Mar 31, 2015
Bryan Keith Winters Individual Corporate DirectorBoard Member Oct 1, 1970
Stan McKee Individual Corporate DirectorBoard Chair Jan 1, 2002
Paul Kelley Individual Corporate DirectorBoard Member Apr 24, 2018
Wendi Alvarado Individual W-2 Managing EmployeeCredentialing May 18, 2009
Alma Paulin Individual Corporate DirectorBoard Member Jun 26, 2018
Nona Jordan Individual Corporate DirectorBoard Member Oct 1, 1997
Paul Painter Individual Corporate DirectorBoard Member Oct 1, 1997
Amy Wade Individual Corporate DirectorBoard Secretary Apr 25, 2017
James Andrew Bench Individual Corporate DirectorBoard Member Oct 1, 2013
Brenda Sue Cregg Individual Corporate DirectorBoard Treasurer Jan 1, 2012

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 5

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": "1430438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772582400000",
    "number": "1821475575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1908",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754031908",
            "telephone_number": "903-454-3025",
            "fax_number": "903-450-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 JOE RAMSEY BLVD E STE A",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754017776",
            "telephone_number": "903-455-4458",
            "fax_number": "903-455-1604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH SERVICE AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-01",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "903-455-5986"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "368577801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carevide",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pediatric Center of Greenville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, TX

Sources for this page

Verify at the official NPI Registry.