NPIMap

Organization Active NPI

Stonewall Memorial Hospital

  • Critical Access Hospital
  • Aspermont, TX
National Provider Identifier
1083612121
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
000666 Issued in TX
Legal business name
STONEWALL MEMORIAL HOSPITAL
Practice address
821 N Broadway St
Aspermont, TX 79502-2029
Phone
(940) 989-3551
Fax
(940) 989-3662
NPI assigned
Jul 12, 2005
Last updated
Feb 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Authorized official

Name
Michael Moorhead
Title
Ceo
Phone
(940) 989-3551

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 00G24G TX
Family Medicine Physician 207Q00000X D4789 TX
Family Medicine Physician 207Q00000X J6646 TX
Psychiatry Physician 2084P0800X H9774 TX
Critical Access Hospital Clinic/Center 261QC0050X 453986 TX
Rural Health Clinic/Center 261QR1300X 453986 TX
Medicare Defined Swing Bed Hospital Unit 275N00000X 000666 TX
Critical Access Hospital 282NC0060X 000666 TX Primary
Clinical Medical Laboratory 291U00000X 45D0600750 TX
Nurse Practitioner 363L00000X F0906010 TX

Addresses

Primary practice location

821 N Broadway St
Aspermont, TX 79502-2029

Mailing address

821 N Broadway St
Aspermont, TX 79502-2029
Phone (940) 989-3551

Other identifiers 9

IdentifierTypeStateIssuer
451318OtherTXMEDICARE
0209926-01MedicaidTX
020992601MedicaidTX
063461001MedicaidTX
127312001OtherTXMEDICARE/MEDICAID CROSSOVER
1649378712OtherTXNP
1972577963OtherTXPHYSICIAN
1538142617OtherTXPHYSICIAN
096502201MedicaidTX

Other names 1

  • Stonewall Memorial Hospital District Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20040228000195 TX Part B Supplier - Clinic/Group Practice 1254228919 Receives reassigned benefits from 16 practitioners
Practice locations: Aspermont, TX
O20040706001374 TX Part A Provider - Critical Access Hospital 1254228919 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
Practice locations: Aspermont, TX
O20040730000716 TX Part A Provider - Rural Health Clinic 1254228919 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aspermont, TX
O20090910000477 TX Part A Provider - Critical Access Hospital 1254228919 Practice locations: Aspermont, TX

NPI to CCN mapping 3

The Medicare certification numbers (CCNs) connected to NPI 1083612121. Details of each certification follow.

Hospital certification: CCN 451318

Legal name
STONEWALL MEMORIAL HOSPITAL
Doing business as
STONEWALL MEMORIAL HOSPITAL DISTRICT
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Mar 1, 2001
Last certification
Jun 19, 2019
Beds
20
Ownership / control type
Hospital district or authority
Organization structure
GovernmentNon-profit
Enrollment address
821 N Broadway St
Aspermont, TX 79502-2029
Main/Primary Hospital Location

Rural health clinic certification: CCN 453986

Legal name
STONEWALL MEMORIAL HOSPITAL
Doing business as
STONEWALL RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 1, 1991
Last certification
Jun 11, 2019
Ownership / control type
Non-profit – church related
Organization structure
GovernmentNon-profit
Enrollment address
819 N Broadway St
Aspermont, TX 79502-2029
Related CCNs
451318

Hospital certification: CCN 45Z318

Legal name
STONEWALL MEMORIAL HOSPITAL
Doing business as
STONEWALL MEMORIAL HOSPITAL DISTRICT
Organization structure
GovernmentNon-profit
Enrollment address
821 N Broadway St
Aspermont, TX 79502-2029
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Stonewall Memorial Hospital DistrictCCN 451318 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Stonewall Memorial Hospital Organization, Aspermont, TX Operational/Managerial Control Nov 6, 2007
Operational/Managerial Control Aug 18, 2009
Lewis Robbins Individual Corporate DirectorCfo Jan 1, 2025
W-2 Managing EmployeeCfo Jan 1, 2025
Michael Moorhead Individual Corporate OfficerCeo Oct 13, 2022
Corporate DirectorCeo Oct 13, 2022
W-2 Managing EmployeeCeo Oct 13, 2022
Corporate OfficerCeo Jan 1, 2024
Corporate DirectorCeo Jan 1, 2024
W-2 Managing EmployeeCeo Jan 1, 2024
Kimberly Lowack Individual W-2 Managing EmployeeBusiness Office Manager Jan 1, 2023

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 3

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

FacilityTypeRoleSince
Stonewall Rural Health ClinicAspermont, TX, CCN 453986 Rural health clinic Operational/Managerial Control Aug 18, 2009
Kent County Rural Health ClinicJayton, TX, CCN 458789 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2014
Spur Rural Health ClinicSpur, TX, CCN 673426 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2015

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 3

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

Practitioners & affiliated clinicians

Practitioners 46

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 46

Affiliated clinicians 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707091200000",
    "number": "1083612121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 N BROADWAY ST",
            "city": "ASPERMONT",
            "state": "TX",
            "postal_code": "795022029",
            "telephone_number": "940-989-3551",
            "fax_number": "940-989-3662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 N BROADWAY ST",
            "city": "ASPERMONT",
            "state": "TX",
            "postal_code": "795022029",
            "telephone_number": "940-989-3551",
            "fax_number": "940-989-3662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONEWALL MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-12",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A",
        "authorized_official_last_name": "MOORHEAD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "940-989-3551"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "00G24G",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "D4789",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J6646",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "H9774",
            "primary": false
        },
        {
            "code": "261QC0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Critical Access Hospital",
            "state": "TX",
            "license": "453986",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "TX",
            "license": "453986",
            "primary": false
        },
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "TX",
            "license": "000666",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "TX",
            "license": "000666",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": "45D0600750",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "F0906010",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "451318",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0209926-01",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020992601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063461001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE/MEDICAID CROSSOVER",
            "identifier": "127312001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP",
            "identifier": "1649378712",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN",
            "identifier": "1972577963",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN",
            "identifier": "1538142617",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096502201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stonewall Memorial Hospital District",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Aspermont, TX

Sources for this page

Verify at the official NPI Registry.