NPIMap

Organization Active NPI

Andrews County Hospital District

Doing business as Permian Regional Medical Center

  • Rural Acute Care Hospital
  • Andrews, TX
National Provider Identifier
1174563779
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
License
000187 Issued in TX
Legal business name
ANDREWS COUNTY HOSPITAL DISTRICT
Doing business as
Permian Regional Medical Center
Practice address
720 Hospital Dr
Andrews, TX 79714-3617
Phone
(432) 464-2200
Fax
(432) 464-2180
NPI assigned
Jun 8, 2006
Last updated
Jul 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Authorized official

Name
Susan Fournier
Title
Cfo
Phone
(432) 464-2107

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X
General Acute Care Hospital 282N00000X 000187 TX
Rural Acute Care Hospital 282NR1301X 000187 TX Primary

Addresses

Primary practice location

720 Hospital Dr
Andrews, TX 79714-3617

Mailing address

720 Hospital Dr
Andrews, TX 79714-3617
Phone (432) 464-2200

Other identifiers 1

IdentifierTypeStateIssuer
127298107MedicaidTX

Other names 1

  • PERMIAN REGIONAL MEDICAL CENTER Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041020001395 TX Part B Supplier - Mammography Center 6002724945 Practice locations: Andrews, TX
O20071127000704 TX Part A Provider - Hospital 6002724945 Practice locations: Andrews, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174563779. Details of each certification follow.

Hospital certification: CCN 450144

Legal name
ANDREWS COUNTY HOSPITAL DISTRICT
Doing business as
PERMIAN REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Sep 30, 2020
Beds
36
Ownership / control type
Hospital district or authority
Organization structure
OtherProprietary
Enrollment address
720 Hospital Dr
Permian Regional Medical Center
Andrews, TX 79714-3617
Other Hospital Practice Location
Hospital subgroups
General

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

Other NPIs with the same Medicare PAC ID 8

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Permian Regional Medical Center Andrews County HoCCN 450144 · All quality measures
Type
Acute Care 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
Tax ID family
Permian Gen Hosp9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

704 Hospital Dr
Andrews, TX 79714
Phone (432) 464-2165

Interoperability endpoints

  • Direct secure messaging: aansari@permian.medalliesdirect.net
  • Direct secure messaging: amandacompton@permian.medalliesdirect.net
  • Direct secure messaging: areddy@permian.medalliesdirect.net
  • Direct secure messaging: bnorris@permian.medalliesdirect.net
  • Direct secure messaging: cmolina@permian.medalliesdirect.net
  • Direct secure messaging: cstansell@permian.medalliesdirect.net
  • Direct secure messaging: ekelley@permian.medalliesdirect.net
  • Direct secure messaging: jhadaondriezek@permian.medalliesdirect.net
  • Direct secure messaging: jparker@permian.medalliesdirect.net
  • Direct secure messaging: mcunningham@permian.medalliesdirect.net
  • Direct secure messaging: mmerriam@permian.medalliesdirect.net
  • Direct secure messaging: pslaughter@permian.medalliesdirect.net
  • Direct secure messaging: reby@permian.medalliesdirect.net
  • Direct secure messaging: rpuri@permian.medalliesdirect.net
  • Direct secure messaging: rwaddingham@permian.medalliesdirect.net
  • Direct secure messaging: sclawson@permian.medalliesdirect.net
  • Direct secure messaging: sfitzgerald@permian.medalliesdirect.net
  • Direct secure messaging: uestrada@permian.medalliesdirect.net

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Manual Gonzales Individual Corporate DirectorBoard Member Jan 1, 2017
Morgan Mason Individual Corporate DirectorChief Financial Officer Oct 1, 2018
W-2 Managing EmployeeChief Financial Officer Oct 1, 2018
Carol Boswell Individual Corporate Director Jun 27, 2007
Donny Booth Individual Corporate DirectorChief Executive Officer Aug 31, 2019
W-2 Managing EmployeeChief Executive Officer Aug 31, 2019
Melody Starcher Individual W-2 Managing EmployeeProvider Enrollment Specialist Oct 18, 2022
Andrea Warnke Individual Corporate DirectorBoard Member Jan 1, 2018
Felicia D Jamison Individual W-2 Managing EmployeeProvider Enrollment Specialist May 23, 2022
Elizabeth Boynton Individual Corporate Director Jun 27, 2007
Jessica Varner Individual Corporate DirectorBoard Member May 1, 2022
Andrews County Hospital District Organization, Andrews, TX Operational/Managerial Control Jan 1, 2003
Sarah Bender Individual Corporate DirectorBoard Member Nov 1, 2023
Mike Sanchez Individual Corporate DirectorBoard Member Nov 1, 2020

Owners & managing parties with NPI records 8

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
Permian Regional Medical CenterAndrews, TX, CCN 45U144 Hospital Operational/Managerial Control Jan 1, 2003
Permian Residential Care CenterAndrews, TX, CCN 676175 Skilled nursing facility 5% Or Greater Direct Ownership Interest
Trustee of the SNF
Adp of the SNF		 Feb 12, 2003
Feb 12, 2003
Feb 12, 2003
Permian Regional Medical Center Home HealthAndrews, TX, CCN 457596 Home health agency Operational/Managerial Control Nov 1, 2009
Andrews Family MedicineAndrews, TX, CCN 458655 Rural health clinic Operational/Managerial Control May 26, 2010
Quick Care ClinicAndrews, TX, CCN 673420 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 2, 2013

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

Practitioners 24

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 24

Affiliated clinicians 69

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

View all 69

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785456000000",
    "number": "1174563779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HOSPITAL DR",
            "city": "ANDREWS",
            "state": "TX",
            "postal_code": "797143617",
            "telephone_number": "432-464-2200",
            "fax_number": "432-524-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 HOSPITAL DR",
            "city": "ANDREWS",
            "state": "TX",
            "postal_code": "797143617",
            "telephone_number": "432-464-2200",
            "fax_number": "432-464-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREWS COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A",
        "authorized_official_last_name": "FOURNIER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "432-464-2107"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TX",
            "license": "000187",
            "primary": false
        },
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "TX",
            "license": "000187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127298107",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD EMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "PERMIAN REGIONAL MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PERMIAN REGIONAL MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Andrews, TX

Sources for this page

Verify at the official NPI Registry.