NPIMap

Organization Active NPI

Throckmorton County Memorial Hosp

  • Medicare Defined Swing Bed Hospital Unit
  • Throckmorton, TX
National Provider Identifier
1023138781
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
000428 Issued in TX
Legal business name
THROCKMORTON COUNTY MEMORIAL HOSP
Practice address
802 N. Minter Ave.
Throckmorton, TX 76483-5357
Phone
(940) 849-2151
Fax
(940) 849-7141
NPI assigned
Mar 29, 2007
Last updated
Dec 8, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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

Authorized official

Name
Mr. Kirby Gober, DVM
Title
Ceo
Phone
(940) 849-2151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 000428 TX Primary

Addresses

Primary practice location

802 N. Minter Ave.
Throckmorton, TX 76483-5357

Mailing address

PO Box 729
Throckmorton, TX 76483-0729
Phone (940) 849-2151

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220722001059 TX Part A Provider - Critical Access Hospital 4082686282 Receives reassigned benefits from 1 practitioner
Practice locations: Throckmorton, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023138781. Details of each certification follow.

Hospital certification: CCN 45Z339

Legal name
THROCKMORTON COUNTY MEMORIAL HOSP
Organization structure
CorporationProprietary
Enrollment address
802 N Minter Ave
Throckmorton, TX 76483-5357
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/throckm-3dd57dc3

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Karla Benson Individual W-2 Managing EmployeeHR/Finances Aug 1, 2016
Kirby Gober Individual Corporate OfficerCeo Jun 20, 2014
Throckmorton County Memorial Hosp Organization, Throckmorton, TX Corporation Operational/Managerial Control Nov 12, 2010

Owners & managing parties with NPI records 3

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
Throckmorton County Memorial HospThrockmorton, TX, CCN 451339 Hospital Operational/Managerial Control Nov 12, 2010
Throckmorton Rural Health ClinicThrockmorton, TX, CCN 458683 Rural health clinic Operational/Managerial Control Jun 29, 2010

Owned or controlled facilities with NPI records 3

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 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.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512691200000",
    "number": "1023138781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 729",
            "city": "THROCKMORTON",
            "state": "TX",
            "postal_code": "764830729",
            "telephone_number": "940-849-2151",
            "fax_number": "940-849-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 N. MINTER AVE.",
            "city": "THROCKMORTON",
            "state": "TX",
            "postal_code": "764835357",
            "telephone_number": "940-849-2151",
            "fax_number": "940-849-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THROCKMORTON COUNTY MEMORIAL HOSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2017-12-08",
        "status": "A",
        "authorized_official_last_name": "GOBER",
        "authorized_official_first_name": "KIRBY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "940-849-2151",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DVM"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "TX",
            "license": "000428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Throckmorton, TX

Sources for this page

Verify at the official NPI Registry.