NPIMap

Organization Active NPI

Huntsville Community Hospital, Inc.

Doing business as Huntsville Memorial Hospital

  • Rural Health Clinic/Center
  • Huntsville, TX
National Provider Identifier
1306484050
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HUNTSVILLE COMMUNITY HOSPITAL, INC.
Doing business as
Huntsville Memorial Hospital
Practice address
125 Medical Park LN Ste C
Huntsville, TX 77340-4957
Phone
(936) 291-3219
Fax
(936) 291-7206
NPI assigned
Dec 12, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Authorized official

Name
Mr. Paul Hanson
Title
Chief Financial Officer
Phone
(936) 291-4514

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Sports Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS0010X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Rural Health Clinic/Center 261QR1300X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Advanced Practice MidwifeGroup: 193200000X MULTI-SPECIALTY GROUP 367A00000X

Addresses

Primary practice location

125 Medical Park LN Ste C
Huntsville, TX 77340-4957

Mailing address

PO Box 4001
Huntsville, TX 77342-4001
Phone (936) 291-3411

Other names 1

  • Huntsville Memorial Hospital Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200501002195 TX Part B Supplier - Clinic/Group Practice 6103255732 Receives reassigned benefits from 18 practitioners
1 other NPI on this enrollment
Practice locations: Huntsville, TX
O20200504001214 TX Part A Provider - Rural Health Clinic 6103255732 Practice locations: Huntsville, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306484050. Details of each certification follow.

Rural health clinic certification: CCN 673976

Legal name
HUNTSVILLE COMMUNITY HOSPITAL, INC.
Doing business as
HUNTSVILLE MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 24, 1992
Last certification
Aug 17, 2016
Ownership / control type
1B
Most recent change of ownership
Feb 28, 2020 (2 total)
Organization structure
CorporationNon-profit
Incorporated
Nov 5, 2019 in TX
Enrollment address
125 Medical Park LN
Ste C
Huntsville, TX 77340-4957
Related CCNs
450347

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).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Huntsville Comm Hosp Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Community Hospital Consulting, Inc Organization, Plano, TX Corporation, Non-profit 5% Or Greater Direct Ownership Interest Feb 28, 2020 100%
Terry Scoggin Individual Corporate OfficerChief Executive Officer Jan 21, 2026
W-2 Managing EmployeeChief Executive Officer Jan 21, 2026
Jim Ronald Kendrick Individual Corporate DirectorPres.and Chairman/Board Feb 28, 2020
Paul Hanson Individual Corporate OfficerChief Financial Officer Sep 30, 2024
W-2 Managing EmployeeChief Financial Officer Sep 30, 2024
Joe Thomason Individual Corporate Director Feb 28, 2020
Charlotte Woodard Individual Corporate Director Feb 28, 2020

Facilities with the same owner 11

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

Change-of-ownership history 1

DateEventCounterparty
Feb 28, 2020 Change of OwnershipThis provider was the buyer Huntsville Memorial HospitalCCN 673976, TX, NPI 1972628816

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

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

NPI Registry JSON

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739836800000",
    "number": "1306484050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4001",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773424001",
            "telephone_number": "936-291-3411",
            "fax_number": "936-291-4394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 MEDICAL PARK LN STE C",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773404957",
            "telephone_number": "936-291-3219",
            "fax_number": "936-291-7206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUNTSVILLE COMMUNITY HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-12",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "936-291-4514",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Huntsville Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Huntsville Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntsville, TX

Sources for this page

Verify at the official NPI Registry.