NPIMap

Organization Active NPI

Community Health Care Systems Inc,

Doing business as Community Health Care Systems, Inc-Twiggs County Public School Wellnes

  • Federally Qualified Health Center (FQHC)
  • Jeffersonville, GA
National Provider Identifier
1881452993
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CARE SYSTEMS INC,
Doing business as
Community Health Care Systems, Inc-Twiggs County Public School Wellnes
Practice address
675 Bullard Rd
Jeffersonville, GA 31044-3314
Phone
(478) 945-6522
Fax
(478) 864-1288
NPI assigned
Mar 12, 2024
Last updated
Mar 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Authorized official

Name
Carla W Belcher
Title
Ceo
Phone
(478) 552-7384

Specialties & licenses 1

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

Addresses

Primary practice location

675 Bullard Rd
Jeffersonville, GA 31044-3314

Mailing address

PO Box 371
Wrightsville, GA 31096-0371
Phone (478) 864-3448

Other names 1

  • COMMUNITY HEALTH CARE SYSTEMS, INC-TWIGGS COUNTY PUBLIC SCHOOL WELLNES Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250122002322 GA Part A Provider - Federally Qualified Health Center (FQHC) 5890783179 Practice locations: Jeffersonville, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881452993. Details of each certification follow.

Federally qualified health center certification: CCN C21027

Legal name
COMMUNITY HEALTH CARE SYSTEMS, INC.
Doing business as
COMMUNITY HEALTHCARE SYSTEMS, INC-TWIGGS CO PUBLIC SCHOOL WELLNESS CT
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 14, 2025
Last certification
Jan 14, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 1, 1992 in GA
Enrollment address
675 Bullard Rd
Jeffersonville, GA 31044-3314

Other NPIs with the same Medicare PAC ID 17

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

View all 17

National Provider Directory

National Provider Directory
Tax ID family
Comm Health Care Sys Inc20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Kristie Brantely Individual Corporate OfficerBoard Member Jan 2, 2024 100%
Cathy Ivey Individual Corporate OfficerChair Person Jan 2, 2024 100%
Michelle Stewart Individual Corporate OfficerBoard Member Jan 2, 2024 100%
David Montford Individual Corporate OfficerBoard Member Jan 2, 2024 100%
John Williams Individual Corporate OfficerVice Chairperson Jan 2, 2024 100%
Lynn W Price Individual W-2 Managing EmployeeInsurance Billing Coordinator Jan 2, 2024 100%
Frank Smith Individual Corporate OfficerBoard Member Jan 2, 2024 100%
Carla Belcher Individual W-2 Managing EmployeeAd; Jan 2, 2024 100%

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Community Health Care Systems, Inc-BaldwinMilledgeville, GA, CCN 111022 Federally qualified health center Operational/Managerial Control Sep 1, 2015
Community Health Care Systems, Inc.Macon, GA, CCN 111112 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 May 22, 2017
May 22, 2017

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1710201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710201600000",
    "number": "1881452993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 371",
            "city": "WRIGHTSVILLE",
            "state": "GA",
            "postal_code": "310960371",
            "telephone_number": "478-864-3448",
            "fax_number": "478-864-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 BULLARD RD",
            "city": "JEFFERSONVILLE",
            "state": "GA",
            "postal_code": "310443314",
            "telephone_number": "478-945-6522",
            "fax_number": "478-864-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CARE SYSTEMS INC,",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-12",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A",
        "authorized_official_last_name": "BELCHER",
        "authorized_official_first_name": "CARLA",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "478-552-7384"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMMUNITY HEALTH CARE SYSTEMS, INC-TWIGGS COUNTY PUBLIC SCHOOL WELLNES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jeffersonville, GA

Sources for this page

Verify at the official NPI Registry.