NPIMap

Organization Active NPI

County of Clay

Doing business as Clay County Memorial Hospital

  • Ambulance
  • Henrietta, TX
National Provider Identifier
1093832784
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
300213 Issued in TX
Legal business name
COUNTY OF CLAY
Doing business as
Clay County Memorial Hospital
Practice address
310 W South St
Henrietta, TX 76365-3346
Phone
(940) 538-5621
Fax
(940) 538-2205
NPI assigned
Mar 26, 2007
Last updated
Jan 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Authorized official

Name
Jeff Huskey
Title
Ceo
Phone
(940) 538-5621

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 300213 TX Primary

Addresses

Primary practice location

310 W South St
Henrietta, TX 76365-3346

Mailing address

310 W South St
Henrietta, TX 76365-3346
Phone (940) 538-5621

Other identifiers 1

IdentifierTypeStateIssuer
109590303MedicaidTX

Other names 1

  • Clay County Memorial Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250212000077 TX Part B Supplier - Ambulance Service Supplier 4981689783 Practice locations: Henrietta, TX

Other NPIs with the same Medicare PAC ID 4

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

  • County of Clay

    dba Clay County Memorial Hospital

    • Critical Access Hospital
    • Henrietta, TX
    • NPI 1437156361

    4981689783

    Same PAC ID
  • County of Clay

    dba Clay County Memorial Hospital

    • Medicare Defined Swing Bed Hospital Unit
    • Henrietta, TX
    • NPI 1518023993

    4981689783

    Same PAC ID
  • County of Clay

    dba Clay County Memorial Hospital

    • Surgery Physician
    • Henrietta, TX
    • NPI 1639340748

    4981689783

    Same PAC ID
  • County of Clay

    dba Clay County Home Health Care

    • Home Health Agency
    • Henrietta, TX
    • NPI 1801803267

    4981689783

    Same PAC ID

National Provider Directory

National Provider Directory
Tax ID family
Clay County Memorial Ho8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Ownership & related parties

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Clay County Memorial HospitalHenrietta, TX, CCN 451362 Hospital 5% Or Greater Direct Ownership Interest Oct 28, 2009
Clay County Memorial HospitalHenrietta, TX, CCN 45Z362 Hospital 5% Or Greater Direct Ownership Interest Oct 28, 2009
Clay County Home Health CareHenrietta, TX, CCN 677277 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Other (100%)		 Jan 1, 2002
Jan 1, 2002
Jan 1, 2002

Owned or controlled facilities with NPI records 5

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

  • County of Clay

    dba Clay County Memorial Hospital

    • Critical Access Hospital
    • Henrietta, TX
    • NPI 1437156361

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • County of Clay

    dba Clay County Memorial Hospital

    • Medicare Defined Swing Bed Hospital Unit
    • Henrietta, TX
    • NPI 1518023993

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • County of Clay

    dba Clay County Memorial Hospital

    • Surgery Physician
    • Henrietta, TX
    • NPI 1639340748

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • County of Clay

    dba Clay County Home Health Care

    • Home Health Agency
    • Henrietta, TX
    • NPI 1801803267

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control, Other

    CMS ownership
  • County of Clay

    dba Clay County Memorial Hospital

    • Critical Access Hospital Clinic/Center
    • Henrietta, TX
    • NPI 1881175776

    5% Or Greater Direct Ownership Interest

    CMS ownership

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1093832784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 W SOUTH ST",
            "city": "HENRIETTA",
            "state": "TX",
            "postal_code": "763653346",
            "telephone_number": "940-538-5621",
            "fax_number": "940-538-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W SOUTH ST",
            "city": "HENRIETTA",
            "state": "TX",
            "postal_code": "763653346",
            "telephone_number": "940-538-5621",
            "fax_number": "940-538-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF CLAY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "HUSKEY",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "940-538-5621"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "TX",
            "license": "300213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109590303",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clay County Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henrietta, TX

Sources for this page

Verify at the official NPI Registry.