NPIMap

Organization Active NPI

Jackson County Hospital District

Doing business as Jackson County Home Health

  • Home Health Agency
  • Edna, TX
National Provider Identifier
1285677401
Registry record updated Sep 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
JACKSON COUNTY HOSPITAL DISTRICT
Doing business as
Jackson County Home Health
Practice address
918 South Wells Street
Edna, TX 77957-3745
Phone
(361) 782-7830
Fax
(361) 781-0812
NPI assigned
Jun 14, 2006
Last updated
Sep 14, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
JACKSON COUNTY HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 14, 2010

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

Authorized official

Name
Mr. William Satrom
Title
Cfo
Phone
(361) 782-5241

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

918 South Wells Street
Edna, TX 77957-3745

Mailing address

1013 S Wells St
Edna, TX 77957-4045
Phone (361) 782-7830

Other identifiers 1

IdentifierTypeStateIssuer
111714502MedicaidTX

Other names 1

  • Jackson County Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120119000351 TX Part A Provider - Home Health Agency 2365423795 Practice locations: Edna, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285677401. Details of each certification follow.

Home health agency certification: CCN 677103

Legal name
JACKSON COUNTY HOSPITAL DISTRICT
Doing business as
JACKSON COUNTY HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 8, 1987
Last certification
Mar 3, 2020
Ownership / control type
Government Operated
Organization structure
OtherNon-profit
Enrollment address
918 South Wells Street
Jackson County Home Health
Edna, TX 77957-3745

Other NPIs with the same Medicare PAC ID 6

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Jackson County Home HealthCCN 677103 · All quality measures
Overall star rating
3.5 of 5
Ownership
Government Operated
Certified
Jul 8, 1987
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy

National Provider Directory

National Provider Directory
Part of
Faisal a Pirzada MD

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Jackson County Hospital District Organization, Edna, TX 5% Or Greater Direct Ownership Interest Oct 31, 2011 100%
Operational/Managerial Control Oct 31, 2011 100%
Lance Smiga Individual Corporate OfficerCeo Jan 1, 2021
Corporate DirectorCeo Jan 1, 2021
W-2 Managing EmployeeCeo Jan 1, 2021
Amy George Individual Corporate DirectorDirector Jan 1, 2021
W-2 Managing EmployeeDirector Jan 1, 2021

Owners & managing parties with NPI records 6

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
Jackson Healthcare CenterEdna, TX, CCN 451363 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2005
Jackson Healthcare CenterEdna, TX, CCN 45Z363 Hospital 5% Or Greater Direct Ownership Interest Jan 1, 2005
Jackson County Medical Clinic of EdnaEdna, TX, CCN 458736 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2005
Jackson County Medical Clinic of GanadoGanado, TX, CCN 673495 Rural health clinic Operational/Managerial Control Oct 1, 2025

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Affiliated clinicians 7

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

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284422400000",
    "number": "1285677401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 S WELLS ST",
            "city": "EDNA",
            "state": "TX",
            "postal_code": "779574045",
            "telephone_number": "361-782-7830",
            "fax_number": "361-781-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 SOUTH WELLS STREET",
            "city": "EDNA",
            "state": "TX",
            "postal_code": "779573745",
            "telephone_number": "361-782-7830",
            "fax_number": "361-781-0812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JACKSON COUNTY HOSPITAL DISTRICT",
        "enumeration_date": "2006-06-14",
        "last_updated": "2010-09-14",
        "status": "A",
        "authorized_official_last_name": "SATROM",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "361-782-5241",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111714502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson County Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edna, TX

Sources for this page

Verify at the official NPI Registry.