NPIMap

Organization Active NPI

CC Healthcare Systems, LLC

Doing business as New Braunfels Rural Health Clinic

  • General Practice Physician
  • New Braunfels, TX
National Provider Identifier
1881922102
Registry record updated Oct 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
G2964 Issued in TX
Legal business name
CC HEALTHCARE SYSTEMS, LLC
Doing business as
New Braunfels Rural Health Clinic
Practice address
705 Landa Street
Suite C
New Braunfels, TX 78130-6163
Phone
(830) 629-3614
Fax
(830) 629-2438
NPI assigned
Nov 24, 2009
Last updated
Oct 10, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2017

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

Authorized official

Name
Ms. Sara Ann Castaneda
Title
Administrator
Phone
(830) 629-3614

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X G2964 TX Primary

Addresses

Primary practice location

705 Landa Street
Suite C
New Braunfels, TX 78130-6163

Mailing address

705 Landa Street
Suite C
New Braunfels, TX 78130-6163
Phone (830) 629-3614

Other identifiers 1

IdentifierTypeStateIssuer
310114903MedicaidTX

Other names 1

  • New Braunfels Rural Health Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170405002374 TX Part B Supplier - Clinic/Group Practice 8123168598 Receives reassigned benefits from 6 practitioners
Practice locations: New Braunfels, TX

National Provider Directory

National Provider Directory

Locations

189 E Austin St
Ste 106
New Braunfels, TX 78130
Phone (830) 214-0902

Practitioners & affiliated clinicians

Practitioners 9

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": "1259020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507593600000",
    "number": "1881922102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 LANDA STREET",
            "address_2": "SUITE C",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781306163",
            "telephone_number": "830-629-3614",
            "fax_number": "830-629-2438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 LANDA STREET",
            "address_2": "SUITE C",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781306163",
            "telephone_number": "830-629-3614",
            "fax_number": "830-629-2438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CC HEALTHCARE SYSTEMS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-24",
        "last_updated": "2017-10-10",
        "status": "A",
        "authorized_official_last_name": "CASTANEDA",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "830-629-3614",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "G2964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "310114903",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Braunfels Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Braunfels, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; 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.