Big Bend Hospital Corporation
Organization Active NPI Rural Health Clinic/Center · Alpine, TX
NPI 1275988669 · NPPES record last updated Jul 7, 2023
Key facts
- NPI
- 1275988669
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- BIG BEND HOSPITAL CORPORATION
- Practice address
- 2600 N State Highway 118
Alpine, TX 79830-2002 - Phone
- (432) 837-0242
- NPI assigned
- May 4, 2016
- Organization subpart
- No
Authorized official
- Name
- Laura J Fey
- Title
- Sr. Director Physician Rev Cycle
- Phone
- (615) 221-3641
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 8
Related certifications (CCN) 1
Facilities with the same owner 32
Practitioners 6
-
Katherine Powers Gonzalez, AG-ACNP, FNP
-
Ruth Melody Hornady, APRN, AGACNP
-
Luis James Ruiz, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Rural health clinic certification: CCN 673457
- Legal name
- BIG BEND HOSPITAL CORPORATION
- Doing business as
- BIG BEND REGIONAL HEALTH CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jun 29, 2017
- Last certification
- Jun 29, 2017
- Ownership / control type
- 1B
- Organization structure
- Corporation · Proprietary
- Incorporated
- Jul 22, 1997 in TX
- Enrollment address
- 2600 N State Highway 118
Alpine, TX 79830-2002 - Related CCNs
- 451378
All disclosed owners & managing parties 13
| Name | Role | Since | Share |
|---|---|---|---|
| Henry Kunath |
Corporate Officer |
Sep 6, 2023 | |
| Corporate Director |
Sep 6, 2023 | ||
| W-2 Managing Employee | Sep 6, 2023 | ||
| Christopher M Harrison |
Corporate Officer |
Apr 1, 2025 | |
| Corporate Director |
Apr 1, 2025 | ||
| Quorum Health Corporation |
5% Or Greater Direct Ownership Interest | Apr 29, 2016 | 100% |
| Goldentree Quorum Health Offshore I LTD |
5% Or Greater Indirect Ownership Interest | Jul 7, 2020 | 7% |
| Gtam Onshore Blocker 2 LLC |
5% Or Greater Indirect Ownership Interest | Dec 20, 2023 | 19.34% |
| Goldentree Distressed Onshore Master Fund III LP |
5% Or Greater Indirect Ownership Interest | Aug 5, 2020 | 6.8% |
| Laura Fey |
Corporate Director |
Aug 27, 2018 | |
| Goldentree Select Offshore Intermediate Fund LP |
5% Or Greater Indirect Ownership Interest | Jul 7, 2020 | 5.44% |
| Goldentree Distressed Master Fund III LTD |
5% Or Greater Indirect Ownership Interest | Jul 7, 2020 | 11% |
| Goldentree Quorum Health Offshore II LTD |
5% Or Greater Indirect Ownership Interest | Jul 7, 2020 | 8.5% |
| Quincy Health LLC |
5% Or Greater Indirect Ownership Interest | Jul 7, 2020 | 100% |
| Steven W Frantz |
Corporate Officer |
Aug 10, 2022 | |
| Corporate Director |
Aug 10, 2022 | ||
| Donald Esposito |
Corporate Officer |
Sep 16, 2021 | |
| Corporate Director |
Sep 16, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20161111001376 | TX | Part a Provider - Rural Health Clinic | 7214918036 | Practice locations: Alpine, TX |
National Provider Directory
- Tax ID family
- Big Bend Regional Medical Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
2600 N State Highway 118
Alpine, TX 79830-2002
Mailing address
2600 N State Highway 118
Alpine, TX 79830-2002
Phone (432) 837-0242
Other providers in Alpine, TX
- Perla Venette Bermudez
- Big Bend Ambulance, PLLC
- Big Bend Family Health and Wellness LLC
- Big Bend Family Practice
- Big Bend Home Care Services LLC
- Big Bend Hospital Corporation
- Big Bend Hospital Corporation
- Big Bend Hospital Corporation
- Big Bend Hospital Corporation
- Big Bend Hospital Corporation
All providers in Alpine, TX · Rural Health Clinic/Center in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.