NPIMap

Organization Active NPI

Anson Hospital District

  • Emergency Medicine Physician
  • Anson, TX
National Provider Identifier
1124125521
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
00F94Y Issued in TX
Legal business name
ANSON HOSPITAL DISTRICT
Practice address
101 Avenue J
Anson, TX 79501-2113
Phone
(325) 823-3231
Fax
(325) 823-3098
NPI assigned
Sep 20, 2006
Last updated
Jun 25, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
ANSON HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Authorized official

Name
Ms. Justa Clark
Title
Ceo
Phone
(325) 823-1154

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 00F94Y TX Primary

Addresses

Primary practice location

101 Avenue J
Anson, TX 79501-2113

Mailing address

101 Avenue J
Anson, TX 79501-2113
Phone (325) 823-3231

Other identifiers 2

IdentifierTypeStateIssuer
093751801MedicaidTX
093751804MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160520000427 TX Part B Supplier - Clinic/Group Practice 4880983428 Receives reassigned benefits from 7 practitioners
Practice locations: Anson, TX

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Anson Hospital District5 organizations share this tax ID, including this one
Part of
Anson Hospital District

Other organizations with this tax ID 4

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

Ownership & related parties

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Anson General HospitalAnson, TX, CCN 670781 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2016
Los Arcos del Norte Care CenterEl Paso, TX, CCN 676283 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2019
Legacy Nursing and RehabilitationBryan, TX, CCN 455351 Skilled nursing facility 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Sep 1, 2025
Sep 1, 2025
Anson Family Wellness ClinicAnson, TX, CCN 673989 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2016

Owned or controlled facilities with NPI records 4

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

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782345600000",
    "number": "1124125521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 AVENUE J",
            "city": "ANSON",
            "state": "TX",
            "postal_code": "795012113",
            "telephone_number": "325-823-3231",
            "fax_number": "325-823-3098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 AVENUE J",
            "city": "ANSON",
            "state": "TX",
            "postal_code": "795012113",
            "telephone_number": "325-823-3231",
            "fax_number": "325-823-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANSON HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANSON HOSPITAL DISTRICT",
        "enumeration_date": "2006-09-20",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JUSTA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "325-823-1154",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "00F94Y",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "093751801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "093751804",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anson, TX

Sources for this page

Verify at the official NPI Registry.