NPIMap

Organization Active NPI

Reeves County Hospital District

Doing business as Reeves Regional Rural Health Clinic

  • Rural Health Clinic/Center
  • Pecos, TX
National Provider Identifier
1073654935
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
000367 Issued in TX
Legal business name
REEVES COUNTY HOSPITAL DISTRICT
Doing business as
Reeves Regional Rural Health Clinic
Practice address
2335 Medical Drive
Pecos, TX 79772-2223
Phone
(432) 447-3551
Fax
(432) 447-5434
NPI assigned
Feb 12, 2007
Last updated
Mar 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Authorized official

Name
Brenda K McKinney
Title
Ceo
Phone
(432) 447-3551

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 000367 TX Primary

Addresses

Primary practice location

2335 Medical Drive
Pecos, TX 79772-2223

Mailing address

2335 Medical Drive
Pecos, TX 79772-2223
Phone (432) 447-3551

Other identifiers 9

IdentifierTypeStateIssuer
091933402MedicaidTX
458579OtherMEDICARE
110081104OtherTXFIRST CARE INS
00H20EOtherTXBLUE CROSS
81M142OtherTXBLUE CROSS BLUE SHIELD
082886501MedicaidTX
091933401MedicaidTX
8B5763OtherTXBLUE CROSS BLUE SHIELD
8R7061OtherTXBLUE CROSS BLUE SHIELD

Other names 1

  • Reeves Regional 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
O20100503000446 TX Part A Provider - Rural Health Clinic 2567353469 Practice locations: Pecos, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073654935. Details of each certification follow.

Rural health clinic certification: CCN 458579

Legal name
REEVES COUNTY HOSPITAL DISTRICT
Doing business as
REEVES REGIONAL RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 18, 1995
Last certification
Nov 16, 2015
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
2335 Medical Dr
Pecos, TX 79772-2251
Related CCNs
451377

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

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Tax ID family
Reeves County HSP Ambu6 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.

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/a7e8884c-0f8a-4040-a7e2-b8409572d6c9/

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Hugh Box Individual Corporate DirectorBoard Member May 14, 2011 20%
Pablo Carrasco Individual Corporate DirectorBoard Member May 6, 2000 20%
Lily Serrano Individual Corporate DirectorBoard Member Nov 3, 2020 20%
Armando Mondragon Individual Corporate DirectorBoard Member Sep 12, 2017 20%
Reeves County Hospital District Organization, Pecos, TX 5% Or Greater Direct Ownership Interest Nov 17, 1995 100%
Operational/Managerial Control Jan 17, 1995 100%
Steven Valenzuela Individual Corporate DirectorBoard Member Sep 12, 2017 20%
Brenda McKinney Individual Corporate DirectorBoard Member May 6, 2000 20%
W-2 Managing EmployeeAsst Administrator Jan 1, 2007

Owners & managing parties with NPI records 6

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
Reeves Regional Home Health & HospicePecos, TX, CCN 677210 Home health agency Operational/Managerial Control Mar 16, 2017
Reeves Regional Home Health & HospicePecos, TX, CCN 451660 Hospice Operational/Managerial Control Mar 16, 2017

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.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679443200000",
    "number": "1073654935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2335 MEDICAL DRIVE",
            "city": "PECOS",
            "state": "TX",
            "postal_code": "797722223",
            "telephone_number": "432-447-3551",
            "fax_number": "432-447-5434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2335 MEDICAL DRIVE",
            "city": "PECOS",
            "state": "TX",
            "postal_code": "797722223",
            "telephone_number": "432-447-3551",
            "fax_number": "432-447-5434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REEVES COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-21",
        "status": "A",
        "authorized_official_last_name": "MCKINNEY",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "432-447-3551"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "TX",
            "license": "000367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091933402",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "458579",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CARE INS",
            "identifier": "110081104",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00H20E",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "81M142",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "082886501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091933401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8B5763",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8R7061",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reeves Regional Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Reeves Regional Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pecos, TX

Sources for this page

Verify at the official NPI Registry.