NPIMap

Organization Active NPI

Christ Community Health Services Augusta, Inc

  • Federally Qualified Health Center (FQHC)
  • Augusta, GA
National Provider Identifier
1992448476
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CHRIST COMMUNITY HEALTH SERVICES AUGUSTA, INC
Practice address
1238 Dantignac St
Augusta, GA 30901-2788
Phone
(706) 922-0600
NPI assigned
Apr 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Authorized official

Name
Ursula Rosa
Title
Credentialing & Privileging Manager
Phone
(706) 922-0600

Specialties & licenses 1

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

Addresses

Primary practice location

1238 Dantignac St
Augusta, GA 30901-2788

Mailing address

PO Box 31164
Augusta, GA 30903-2964
Phone (706) 922-0600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080401000769 GA Part B Supplier - Clinic/Group Practice 6608953633 Receives reassigned benefits from 32 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Augusta, GA
O20220601000295 GA Part A Provider - Federally Qualified Health Center (FQHC) 6608953633 Practice locations: Augusta, GA

Federally qualified health center certification: CCN 851168

Legal name
CHRIST COMMUNITY HEALTH SERVICES AUGUSTA, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 18, 2022
Last certification
May 18, 2022
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Nov 1, 2007 in GA
Enrollment address
1238 Dantignac St
Augusta, GA 30901-2788

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2269573Christ Community Health Services Augusta1238 Dantignac Street, Augusta, GA 30901Certificate of waiverSep 28, 2026

National Provider Directory

National Provider Directory
Tax ID family
Christ Community Health Services Augusta Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Johnie Tillman Individual Corporate DirectorBoard Chair Feb 28, 2022
Jacqueline C Heider Individual Corporate DirectorBoard Member Mar 24, 2025
Michael Amos Meyers Individual Corporate DirectorBoard Member Apr 22, 2024
Ursula Shanerra Rosa Individual W-2 Managing EmployeeCredentialing and Privileging Manag Jan 1, 2024
Christie a Densmore Individual Corporate OfficerCfo Feb 1, 2025
W-2 Managing EmployeeCfo Feb 1, 2025
Christ Community Health Services Augusta, Inc. Organization, Augusta, GA Non-profit Operational/Managerial Control Jul 1, 2007 100%
Robert a Campbell Individual W-2 Managing EmployeeMD; Nov 1, 2007
Willie Jerome Jackson Individual Corporate OfficerCeo Apr 14, 2025
W-2 Managing EmployeeCeo Apr 14, 2025
Elisabeth Conrad Becton Individual Corporate DirectorBoard Vice Chair Mar 24, 2025
Alicia B Elam Individual Corporate DirectorBoard Member Apr 22, 2024

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Christ Community Health Services Augusta, Inc.Augusta, GA, CCN 111953 Federally qualified health center Operational/Managerial Control Jul 1, 2007
Christ Community Health Services Augusta, Inc.Augusta, GA, CCN 111954 Federally qualified health center Operational/Managerial Control Jul 1, 2007

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1649894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753660800000",
    "number": "1992448476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31164",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309032964",
            "telephone_number": "706-922-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1238 DANTIGNAC ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012788",
            "telephone_number": "706-922-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRIST COMMUNITY HEALTH SERVICES AUGUSTA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-14",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A",
        "authorized_official_last_name": "ROSA",
        "authorized_official_first_name": "URSULA",
        "authorized_official_title_or_position": "CREDENTIALING & PRIVILEGING MANAGER",
        "authorized_official_telephone_number": "706-922-0600"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.