NPIMap

Organization Active NPI

Crane County Hospital District

  • Rural Health Clinic/Center
  • Crane, TX
National Provider Identifier
1073763439
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
008726 Issued in TX
Legal business name
CRANE COUNTY HOSPITAL DISTRICT
Practice address
1310 'A' S. Alford St
Crane, TX 79731-3801
Phone
(432) 558-3555
Fax
(432) 558-3443
NPI assigned
Sep 23, 2008
Last updated
Jun 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Authorized official

Name
Ms. Laci Harris, MSN, MBA, RN
Title
Clinic Administrator
Phone
(432) 558-3555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 008726 TX Primary

Addresses

Primary practice location

1310 'A' S. Alford St
Crane, TX 79731-3801

Mailing address

1310 'A' S. Alford St
Crane, TX 79731-3801
Phone (432) 558-3555

Other identifiers 2

IdentifierTypeStateIssuer
111551103MedicaidTX
111551102MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090126000578 TX Part A Provider - Rural Health Clinic 4880760222 Practice locations: Crane, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073763439. Details of each certification follow.

Rural health clinic certification: CCN 453423

Legal name
CRANE COUNTY HOSPITAL DISTRICT
Doing business as
CRANE COUNTY RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 9, 1993
Last certification
Oct 17, 2017
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
1310 S Alford St
Ste a
Crane, TX 79731-3801
Related CCNs
451353

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

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Crane Memorial Hospital3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1310 S Alford St
Ste A
Crane, TX 79731
Phone (432) 558-3555

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/cranemh-eecf39fd

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Benjamin Fuentes Individual Corporate DirectorBoard Member Jan 15, 2016
Ty Golliher Individual Corporate DirectorBoard Member Jul 22, 2020
Kim Harrelson Individual Corporate Director Oct 1, 2008
Brandy N Brown Individual Corporate Director Feb 16, 2023
W-2 Managing EmployeeBusiness Office Manager Jul 15, 2020
Crane County Hospital District Organization, Crane, TX 5% Or Greater Direct Ownership Interest Oct 1, 2008
Laci Shea Harris Individual Corporate DirectorCeo May 22, 2023
W-2 Managing EmployeeCeo May 22, 2023
Cherri Brents Individual Corporate Director Oct 1, 2008
Rosemary Cavazos Individual Corporate OfficerBoard Member Jul 22, 2025
Julie Hardcastle Individual Corporate DirectorBoard Member May 24, 2022

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Crane County Hospital DistrictCrane, TX, CCN 451353 Hospital 5% Or Greater Direct Ownership Interest Oct 1, 2008

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1073763439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 'A' S. ALFORD ST",
            "city": "CRANE",
            "state": "TX",
            "postal_code": "797313801",
            "telephone_number": "432-558-3555",
            "fax_number": "432-558-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 'A' S. ALFORD ST",
            "city": "CRANE",
            "state": "TX",
            "postal_code": "797313801",
            "telephone_number": "432-558-3555",
            "fax_number": "432-558-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRANE COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-23",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "LACI",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "432-558-3555",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSN, MBA, RN"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "TX",
            "license": "008726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111551103",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111551102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crane, TX

Sources for this page

Verify at the official NPI Registry.