NPIMap

Organization Active NPI

Palo Pinto County Hospital District

  • Hospitalist Physician
  • Mineral Wells, TX
National Provider Identifier
1104874767
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
00J25T Issued in TX
Legal business name
PALO PINTO COUNTY HOSPITAL DISTRICT
Practice address
400 SW 25TH Ave
Mineral Wells, TX 76067-8246
Phone
(940) 325-7891
Fax
(940) 328-6523
NPI assigned
May 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Authorized official

Name
Ross Korkmas
Title
Ceo
Phone
(940) 325-7891

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X 00J25T TX
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X 00J25T TX Primary
Ambulatory Family Planning Facility 261QA0005X
Emergency Care Clinic/Center 261QE0002X 00J25T TX
Acute Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2100X 00J25T TX
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

400 SW 25TH Ave
Mineral Wells, TX 76067-8246

Mailing address

400 SW 25TH Ave
Mineral Wells, TX 76067-8246
Phone (940) 325-7891

Other practice location 1

101 Holly Hill Rd Ste B
Mineral Wells, TX 76067-5005
Phone (940) 463-7101

Other identifiers 3

IdentifierTypeStateIssuer
CD2070OtherTXMEDICARE RAILROAD
138950418MedicaidTX
CC2933OtherTXMEDICARE RAILROAD

Other names 3

  • PALO PINTO GENERAL HOSPITAL Doing business as
  • PALO PINTO MAMMOGRAPHY Doing business as
  • PPGH HOSPITALIST GROUP Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000393 TX Part B Supplier - Clinic/Group Practice 5890602759 Receives reassigned benefits from 84 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mineral Wells, TX; Santo, TX; Graford, TX; Gordon, TX

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Palo Pinto Hospital District Community Clinic26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Locations

202 SW 25th Ave
Mineral Wells, TX 76067
Phone (940) 328-7507

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786492800000",
    "number": "1104874767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SW 25TH AVE",
            "city": "MINERAL WELLS",
            "state": "TX",
            "postal_code": "760678246",
            "telephone_number": "940-325-7891",
            "fax_number": "940-328-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SW 25TH AVE",
            "city": "MINERAL WELLS",
            "state": "TX",
            "postal_code": "760678246",
            "telephone_number": "940-325-7891",
            "fax_number": "940-328-6523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Holly Hill Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Mineral Wells",
            "state": "TX",
            "postal_code": "760675005",
            "country_code": "US",
            "telephone_number": "940-463-7101",
            "fax_number": "940-463-7102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PALO PINTO COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A",
        "authorized_official_last_name": "KORKMAS",
        "authorized_official_first_name": "ROSS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "940-325-7891"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "00J25T",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "00J25T",
            "primary": true
        },
        {
            "code": "261QA0005X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Family Planning Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "TX",
            "license": "00J25T",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "00J25T",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CD2070",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138950418",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CC2933",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PALO PINTO GENERAL HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PALO PINTO MAMMOGRAPHY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PALO PINTO MAMMOGRAPHY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PPGH HOSPITALIST GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mineral Wells, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.