NPIMap

Organization Active NPI

Bosque County Hospital District

Doing business as Goodall-Witcher Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Clifton, TX
National Provider Identifier
1154883692
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
BOSQUE COUNTY HOSPITAL DISTRICT
Doing business as
Goodall-Witcher Hospital
Practice address
101 Posey Ave
Clifton, TX 76634-1289
Phone
(254) 675-8322
Fax
(254) 675-2246
NPI assigned
Apr 3, 2019
Last updated
Aug 10, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
BOSQUE COUNTY HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Authorized official

Name
Adam Willmann
Title
President/Ceo
Phone
(254) 675-8322

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

Primary practice location

101 Posey Ave
Clifton, TX 76634-1289

Mailing address

PO Box 549
Clifton, TX 76634-0549
Phone (254) 675-8322

Other names 1

  • Goodall-Witcher Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190610000200 TX Part A Provider - Critical Access Hospital 4587997754 Practice locations: Clifton, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154883692. Details of each certification follow.

Hospital certification: CCN 45Z385

Legal name
BOSQUE COUNTY HOSPITAL DISTRICT
Doing business as
GOODALL-WITCHER HOSPITAL
Organization structure
OtherNon-profit
Enrollment address
101 Posey Ave
Clifton, TX 76634-1289
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).

National Provider Directory

National Provider Directory
Tax ID family
Bosque County Hospital District7 organizations share this tax ID, including this one
Part of
Bosque County Hospital District

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Vicki Gloff Individual Corporate DirectorCfo Dec 1, 2014
W-2 Managing EmployeeCfo Dec 1, 2014
Jerry L Pickett Individual Corporate DirectorCfo Jun 24, 2019
W-2 Managing EmployeeCfo Jun 24, 2019
Charles Hopkins Individual Corporate OfficerBoard Director Jan 14, 2019
Roger Parks Individual Corporate OfficerSecretary/Treasurer Jan 14, 2019
Bosque County Hospital District Organization, Clifton, TX 5% Or Greater Direct Ownership Interest Jul 1, 2019 100%
Operational/Managerial Control Jul 1, 2019 100%
Thomas Blossom Individual Corporate DirectorBoard Director May 22, 2020
Virginia Villarreal Individual Corporate OfficerBoard Director Jan 14, 2019
George Clifton Individual Corporate OfficerBoard Director Jan 14, 2019
Adam B Willmann Individual Corporate DirectorPresident/Ceo Dec 1, 2014
W-2 Managing EmployeePresident/Ceo Dec 1, 2014
Robert Phillips Individual Corporate OfficerBoard Director May 1, 2023
John Erickson Individual Corporate OfficerBoard Vice Chairman Jan 14, 2019

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 5

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

FacilityTypeRoleSince
Goodall-Witcher HospitalClifton, TX, CCN 451385 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 2019
Jul 1, 2019
Sunset HomeClifton, TX, CCN 675826 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Jul 1, 2019
Jul 1, 2019
Jul 2, 2025
Goodall-Witcher Home Health AgencyClifton, TX, CCN 457688 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2019
Goodall-Witcher Clinic in CliftonClifton, TX, CCN 673995 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2019
Goodall-Witcher Clinic in WhitneyWhitney, TX, CCN 673436 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2019

Owned or controlled facilities with NPI records 5

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

Facilities with the same owner 5

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

Practitioners & affiliated clinicians

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1154883692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 549",
            "city": "CLIFTON",
            "state": "TX",
            "postal_code": "766340549",
            "telephone_number": "254-675-8322",
            "fax_number": "254-675-2246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 POSEY AVE",
            "city": "CLIFTON",
            "state": "TX",
            "postal_code": "766341289",
            "telephone_number": "254-675-8322",
            "fax_number": "254-675-2246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSQUE COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOSQUE COUNTY HOSPITAL DISTRICT",
        "enumeration_date": "2019-04-03",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A",
        "authorized_official_last_name": "WILLMANN",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "254-675-8322"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goodall-Witcher Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clifton, TX

Sources for this page

Verify at the official NPI Registry.