NPIMap

Organization Active NPI

Mitchell County Hospital District

  • Critical Access Hospital
  • Colorado City, TX
National Provider Identifier
1184631673
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
75 Issued in TX
Legal business name
MITCHELL COUNTY HOSPITAL DISTRICT
Practice address
997 West Interstate 20
Colorado City, TX 79512-2685
Phone
(325) 728-3431
Fax
(325) 728-8974
NPI assigned
Aug 1, 2006
Last updated
Sep 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Authorized official

Name
Ms. Suzanne Michelle Gafford
Title
Ceo
Phone
(325) 728-3431

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Critical Access Hospital 282NC0060X 75 TX Primary
Institutional Pharmacy 3336I0012X

Addresses

Primary practice location

997 West Interstate 20
Colorado City, TX 79512-2685

Mailing address

997 West Interstate 20
Colorado City, TX 79512-2685
Phone (325) 728-3431

Other identifiers 2

IdentifierTypeStateIssuer
45Z342OtherTXSWINGBED PROGRAM FOR CAH
136325111MedicaidTX

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040614001226 TX Part B Supplier - Clinic/Group Practice 9739071176 Receives reassigned benefits from 18 practitioners
Practice locations: Colorado City, TX; Sweetwater, TX
O20101028001349 TX Part A Provider - Critical Access Hospital 9739071176 Receives reassigned benefits from 4 practitioners
Practice locations: Colorado City, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184631673. Details of each certification follow.

Hospital certification: CCN 451342

Legal name
MITCHELL COUNTY HOSPITAL DISTRICT
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 1, 2003
Last certification
Nov 1, 2016
Beds
25
Ownership / control type
Hospital district or authority
Organization structure
GovernmentNon-profit
Incorporated
Jan 1, 1967 in TX
Enrollment address
997 W Interstate 20
Colorado City, TX 79512-2685

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

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Mitchell County Hospital DistrictCCN 451342 · All quality measures
Type
Critical Access 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

Locations

997 W Interstate 20
Colorado City, TX 79512
Phone (325) 728-3431

301 Jenny George Ln
Bldg A
Sweetwater, TX 79556

301 Jenny George Ln
Ste A
Sweetwater, TX 79556

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
Patricia G Pharis Individual Corporate DirectorBoard Member May 22, 2007
Henryk Olstowski Individual Corporate DirectorBoard Member Mar 22, 2022
Suzanne Michelle Gafford Individual Corporate DirectorChief Executive Officer Dec 1, 2022
W-2 Managing EmployeeChief Executive Officer Dec 1, 2022
Cheryl Warren Individual Corporate DirectorBoard Member Apr 30, 2013
Helen Edwards Individual Corporate DirectorBoard Member Nov 1, 2019
Robert Hall Individual Corporate DirectorChief Operating Officer Sep 1, 2022
W-2 Managing EmployeeChief Operating Officer Sep 1, 2022
Rural Hospital Management Organization, Lubbock, TX Management services company Operational/Managerial Control Sep 16, 2008
Randall Anderson Individual Corporate DirectorBoard Member Apr 27, 2021
Marsha Rickard Individual Corporate DirectorBoard Member May 18, 2016
Maria Rubio Individual Corporate DirectorBoard Member Jul 24, 2018
Diane C Moore Individual Corporate DirectorChief Financial Officer Apr 24, 2023
W-2 Managing EmployeeChief Financial Officer Apr 24, 2023
Mitchell County Hospital District Organization, Colorado City, TX Operational/Managerial Control Sep 1, 2010

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Mitchell County Hospital DistrictColorado City, TX, CCN 45Z342 Hospital Operational/Managerial Control Sep 1, 2010
Mitchell County Nursing and Rehabilitation CenterColorado City, TX, CCN 676225 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Jan 1, 1967
Dec 30, 2024
Jan 14, 2025
Family Medical AssociatesColorado City, TX, CCN 453403 Rural health clinic Operational/Managerial Control (100%) Jan 1, 1992

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.

Practitioners & affiliated clinicians

Practitioners 18

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 18

Affiliated clinicians 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1184631673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "997 WEST INTERSTATE 20",
            "city": "COLORADO CITY",
            "state": "TX",
            "postal_code": "795122685",
            "telephone_number": "325-728-3431",
            "fax_number": "325-728-8974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "997 WEST INTERSTATE 20",
            "city": "COLORADO CITY",
            "state": "TX",
            "postal_code": "795122685",
            "telephone_number": "325-728-3431",
            "fax_number": "325-728-8974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITCHELL COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "GAFFORD",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "325-728-3431",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "TX",
            "license": "75",
            "primary": true
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SWINGBED PROGRAM FOR CAH",
            "identifier": "45Z342",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136325111",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado City, TX

Sources for this page

Verify at the official NPI Registry.