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Clayton Health Systems, Inc

Organization Active NPI Rural Health Clinic/Center · Clayton, NM

NPI 1265897151 · NPPES record last updated Sep 23, 2024

Key facts

NPI
1265897151
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
License
3060 (NM)
Legal business name
CLAYTON HEALTH SYSTEMS, INC
Practice address
314 N 3Rd Ave
Clayton, NM 88415-3302
Phone
(575) 374-2273
Fax
(575) 374-0903
NPI assigned
Dec 21, 2015
Organization subpart
No

Authorized official

Name
Tammie Chavez
Title
Ceo
Phone
(575) 374-2585

Owners & managing parties with NPI records 4

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

Owned or controlled facilities with NPI records 2

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

Other NPIs with the same Medicare PAC ID 4

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

Corporate family (same tax ID) 5

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

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

Facilities with the same owner 2

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

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NM

Rural health clinic certification: CCN 323406

Legal name
CLAYTON HEALTH SYSTEMS INC
Doing business as
UNION COUNTY HEALTH CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 7, 2018
Last certification
Jun 12, 2024
Ownership / control type
2B
Organization structure
Corporation · Non-profit
Incorporated
Jun 11, 2001 in NM
Enrollment address
314 North 3Rd Avenue
Clayton, NM 88415-3302
Related CCNs
321304

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Clayton Health Systems Inc
Organization · Clayton, NM
Corporation, Non-profit 		5% Or Greater Direct Ownership Interest Oct 18, 2016 100%
Operational/Managerial Control Oct 18, 2016 100%
Terry Lancaster
Individual 		Corporate Officer
Cfo		 Mar 3, 2025
Brian Roland
Individual 		Corporate Officer
Chief Executive Officer		 Feb 23, 2026
Judith D Cooper
Individual 		5% Or Greater Direct Ownership Interest Aug 11, 2014 5%
Corporate Officer
Board President		 Aug 11, 2014 5%
Corporate Director
Board President		 Aug 11, 2014
Operational/Managerial Control
Board President		 Aug 11, 2014 5%
Tammie U Chavez
Individual 		Corporate Officer
Ceo		 Sep 17, 2024 5%
W-2 Managing Employee
Ceo		 Sep 17, 2024 5%
Operational/Managerial Control
Ceo		 Sep 17, 2024 5%

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Union County General Hospital
Clayton, NM · CCN 321304		 Hospital Operational/Managerial Control Sep 1, 2008
Union County General Hospital
Clayton, NM · CCN 32Z304		 Hospital Operational/Managerial Control (100%) Sep 1, 2008
Union County General Hospital
Des Moines, NM · CCN 323414		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2020
Jan 1, 2020

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20170523001307 NM Part a Provider - Rural Health Clinic 0941195895 Practice locations: Clayton, NM

National Provider Directory

Tax ID family
Clayton Health System (6 organizations share this tax ID)

Locations

314 N 3rd Ave
Clayton, NM 88415
Phone (575) 374-2273

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 3060 NM Yes

Addresses

Primary practice location

314 N 3Rd Ave
Clayton, NM 88415-3302

Mailing address

300 Wilson St
Clayton, NM 88415-3304
Phone (575) 374-2273

Other names

  • UNION COUNTY HEALTH CENTER Doing business as

Other providers in Clayton, NM

All providers in Clayton, NM · Rural Health Clinic/Center in New Mexico

Sources for this page

Verify at the official NPI Registry.