NPIMap

Organization Active NPI

Core Health Systems

  • Federally Qualified Health Center (FQHC)
  • Jefferson, TX
National Provider Identifier
1851235204
Registry record updated Oct 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CORE HEALTH SYSTEMS
Practice address
1113 North Walcott Street Ste B
Jefferson, TX 75657-1041
Phone
(903) 758-2471
Fax
(903) 234-1639
NPI assigned
Apr 16, 2026
Last updated
Oct 19, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2026

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

Authorized official

Name
Rosemary O Villarreal, PESC
Title
Provider Enrollment/Cred Specialist
Phone
(903) 932-3779

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Physician Assistant 363A00000X
Family Nurse Practitioner 363LF0000X
General Practice Physician 208D00000X

Addresses

Primary practice location

1113 North Walcott Street Ste B
Jefferson, TX 75657-1041

Mailing address

107 Woodbine PL
Longview, TX 75601-2912
Phone (903) 758-2471

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260529003894 TX Part B Supplier - Clinic/Group Practice 9234599424 Receives reassigned benefits from 3 practitioners
Practice locations: Jefferson, TX

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Core Health Systems2 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

107 Woodbine Pl
Longview, TX 75601
Phone (800) 446-8253

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": "1776297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792368000000",
    "number": "1851235204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 WOODBINE PL",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756012912",
            "telephone_number": "903-758-2471",
            "fax_number": "903-234-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 NORTH WALCOTT STREET STE B",
            "city": "JEFFERSON",
            "state": "TX",
            "postal_code": "756571041",
            "telephone_number": "903-758-2471",
            "fax_number": "903-234-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE HEALTH SYSTEMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-16",
        "last_updated": "2026-10-19",
        "certification_date": "2026-10-19",
        "status": "A",
        "authorized_official_last_name": "VILLARREAL",
        "authorized_official_first_name": "ROSEMARY",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT/CRED SPECIALIST",
        "authorized_official_telephone_number": "903-932-3779",
        "authorized_official_credential": "PESC"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.