NPIMap

Organization Active NPI

Yoakum Community Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Yoakum, TX
National Provider Identifier
1295839496
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
000023 Issued in TX
Legal business name
YOAKUM COMMUNITY HOSPITAL
Practice address
1200 Carl Ramert Drive
Yoakum, TX 77995
Phone
(361) 293-2321
Fax
(361) 293-3490
NPI assigned
Sep 11, 2006
Last updated
Apr 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Authorized official

Name
Miss Tiffany Miller
Title
Ceo
Phone
(361) 293-2321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 000023 TX Primary

Addresses

Primary practice location

1200 Carl Ramert Drive
Yoakum, TX 77995

Mailing address

1200 Carl Ramert Drive
Yoakum, TX 77995
Phone (361) 293-2321

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100204000426 TX Part A Provider - Critical Access Hospital 5193621159 Practice locations: Yoakum, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295839496. Details of each certification follow.

Hospital certification: CCN 45Z346

Legal name
YOAKUM COMMUNITY HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Feb 22, 1984 in TX
Enrollment address
1200 Carl Ramert Dr
Yoakum, TX 77995-4868
Hospital Swing-Bed Unit

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

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Charles P Clarke MD3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
John Olivares Individual Corporate OfficerCfo Apr 1, 2015
Lindsey Lacina Individual Corporate Director Dec 31, 2022
Community Hospital Consulting, Inc Organization, Plano, TX Corporation, Non-profit 5% Or Greater Direct Ownership Interest Sep 1, 1998 100%
Saundra R Anderson Individual Corporate DirectorMember, Board of Directors Jan 1, 2016
Phillip Fitch Individual Corporate Director Dec 31, 2021
Clay Hermann Individual Corporate DirectorTax District Representative on T Jan 1, 2017
Bruce Bayless Individual Corporate Director Dec 31, 2022
Sherri Kusak Individual Corporate Director Dec 31, 2021
Jim Ronald Kendrick Individual Corporate DirectorMember Board of Directors Feb 1, 2017
Tiffany Miller Individual Corporate OfficerChief Executive Officer Jan 23, 2023
W-2 Managing EmployeeChief Executive Officer Jan 23, 2023
Marvin J Boedeker Individual Corporate DirectorMember, Board of Directors Jan 1, 2005
Jeffrey Pesek Individual Corporate Director Dec 31, 2021
Ronald Leck Individual Corporate DirectorMember, Board of Directors Jan 1, 2016
Larry Leahy Individual Corporate DirectorMember, Board of Directors Jan 1, 2016
Thomas B Kelly Individual Corporate Director Dec 31, 2021

Owners & managing parties with NPI records 1

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

Facilities with the same owner 11

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

Practitioners & affiliated clinicians

Practitioners 10

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.

Affiliated clinicians 5

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": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681689600000",
    "number": "1295839496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CARL RAMERT DRIVE",
            "city": "YOAKUM",
            "state": "TX",
            "postal_code": "77995",
            "telephone_number": "361-293-2321",
            "fax_number": "361-293-3490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CARL RAMERT DRIVE",
            "city": "YOAKUM",
            "state": "TX",
            "postal_code": "77995",
            "telephone_number": "361-293-2321",
            "fax_number": "361-293-3490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOAKUM COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-11",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "361-293-2321",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "TX",
            "license": "000023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yoakum, TX

Sources for this page

Verify at the official NPI Registry.