NPIMap

Organization Active NPI

Stonewall Memorial Hospital

Doing business as Stonewall Rural Health Clinic

  • Rural Health Clinic/Center
  • Aspermont, TX
National Provider Identifier
1184057598
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
STONEWALL MEMORIAL HOSPITAL
Doing business as
Stonewall Rural Health Clinic
Practice address
819 N Broadway St
Aspermont, TX 79502-2029
Phone
(940) 989-2875
NPI assigned
Aug 21, 2013
Last updated
Jul 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Authorized official

Name
Michael Moorhead
Title
Ceo
Phone
(940) 940-3551

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

819 N Broadway St
Aspermont, TX 79502-2029

Mailing address

821 N Broadway St
Aspermont, TX 79502-2029
Phone (940) 989-3551

Other names 1

  • Stonewall Rural Health Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040730000716 TX Part A Provider - Rural Health Clinic 1254228919 1 other NPI on this enrollment
Practice locations: Aspermont, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184057598. Details of each certification follow.

Rural health clinic certification: CCN 453986

Legal name
STONEWALL MEMORIAL HOSPITAL
Doing business as
STONEWALL RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 1, 1991
Last certification
Jun 11, 2019
Ownership / control type
Non-profit – church related
Organization structure
GovernmentNon-profit
Enrollment address
819 N Broadway St
Aspermont, TX 79502-2029
Related CCNs
451318

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).

Other NPIs on the same Medicare enrollment 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0686678Stonewall Rural Health Clinic819 N Broadway St, Aspermont, TX 79502Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Stonewall County Ambulance7 organizations share this tax ID, including this one

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 2

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

NameRoleSinceShare
Stonewall Memorial Hospital Organization, Aspermont, TX Non-profit Operational/Managerial Control Aug 18, 2009
Michael Moorhead Individual Corporate OfficerCeo Jan 1, 2024
Corporate DirectorCeo Jan 1, 2024
W-2 Managing EmployeeCeo Jan 1, 2024

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 4

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

FacilityTypeRoleSince
Stonewall Memorial Hospital DistrictAspermont, TX, CCN 451318 Hospital Operational/Managerial Control Nov 6, 2007
Stonewall Memorial Hospital DistrictAspermont, TX, CCN 45Z318 Hospital Operational/Managerial Control Nov 6, 2007
Kent County Rural Health ClinicJayton, TX, CCN 458789 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2014
Spur Rural Health ClinicSpur, TX, CCN 673426 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2015

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

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

NPI Registry JSON

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

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1184057598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 N BROADWAY ST",
            "city": "ASPERMONT",
            "state": "TX",
            "postal_code": "795022029",
            "telephone_number": "940-989-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 N BROADWAY ST",
            "city": "ASPERMONT",
            "state": "TX",
            "postal_code": "795022029",
            "telephone_number": "940-989-2875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONEWALL MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-21",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "MOORHEAD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "940-940-3551"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stonewall Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aspermont, TX

Sources for this page

Verify at the official NPI Registry.