NPIMap

Organization Active NPI

Mitchell County Hospital District

  • Skilled Nursing Facility
  • Colorado City, TX
National Provider Identifier
1306832092
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
142095 Issued in TX
Legal business name
MITCHELL COUNTY HOSPITAL DISTRICT
Practice address
971 W Interstate 20
Colorado City, TX 79512-2685
Phone
(325) 728-5247
Fax
(325) 728-5006
NPI assigned
Sep 27, 2005
Organization subpart
Yes
Parent organization
MITCHELL COUNTY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Authorized official

Name
Suzanne Michelle Gafford
Title
Ceo
Phone
(325) 728-3431

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 142095 TX Primary

Addresses

Primary practice location

971 W Interstate 20
Colorado City, TX 79512-2685

Mailing address

971 W Interstate 20
Colorado City, TX 79512-2685
Phone (325) 728-5247

Other identifiers 1

IdentifierTypeStateIssuer
000422101MedicaidTX

Other names 1

  • Mitchell County Nursing & Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090421000750 TX Part A Provider - Skilled Nursing Facility 9739071176 Practice locations: Colorado City, TX

Skilled nursing facility certification: CCN 676225

Legal name
MITCHELL COUNTY HOSPITAL DISTRICT
Doing business as
MITCHELL COUNTY NURSING AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 15, 2009
Last certification
Feb 20, 2025
Beds
54
Ownership / control type
Hospital District
Organization structure
OtherNon-profit
Enrollment address
971 W Interstate 20
Colorado City, TX 79512-2685
Nursing home name
MITCHELL COUNTY NURSING AND REHABILITATION CENTER

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Mitchell County Nursing and Rehabilitation CenterCCN 676225
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Government - Hospital district
Certified
Oct 15, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5445.9 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0983316Mitchell County Nursing & Rehabilitation Center971 West Interstate 20, Colorado City, TX 79512Certificate of waiverFeb 20, 2027

National Provider Directory

National Provider Directory
Tax ID family
Mitchell County Hospital11 organizations share this tax ID, including this one
Part of
Mitchell County Hospital

Other organizations with this tax ID 10

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

Locations

971 W Interstate 20
Colorado City, TX 79512
Phone (325) 728-5247

1941 Chestnut St
Colorado City, TX 79512
Phone (325) 728-5247

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/mitchco-ec738402

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Ruth Pereida Individual Operational/Managerial Control Aug 25, 2025
Adp of the SNF Aug 21, 2025
Henryk Olstowski Individual Corporate DirectorBoard Member Mar 22, 2022
Suzanne Michelle Gafford Individual Corporate DirectorChief Executive Officer Dec 1, 2022
Operational/Managerial Control Feb 3, 2023
Managing Control - Governing BodyChief Executive Officer Feb 3, 2023
Adp of the SNF Feb 3, 2023
Kaleb Jackson Individual Corporate DirectorBoard Member May 23, 2023
Helen Edwards Individual Corporate DirectorBoard Member Jan 9, 2020
Robert Hall Individual Corporate DirectorChief Operating Officer Jan 1, 2022
Operational/Managerial Control Feb 3, 2023
Managing Control - Governing BodyChef Operations Officer Feb 3, 2023
Adp of the SNF Feb 3, 2023
Rural Hospital Management Organization, Lubbock, TX Management services company Operational/Managerial Control Jun 2, 2012 100%
Adp of the SNF Jan 14, 2025
Marsha Rickard Individual Corporate DirectorBoard Member Apr 21, 2016
Richy Womack Individual Corporate DirectorBoard Member Feb 8, 2024
Maria Rubio Individual Corporate DirectorBoard Member Jul 24, 2018
Dee a Roach Individual Adp of the SNF Jan 1, 2024
Diane C Moore Individual Corporate DirectorChief Financial Officer Apr 24, 2023
Managing Control - Governing BodyChief Financial Officer Apr 24, 2023
Adp of the SNF Apr 3, 2023
Mitchell County Hospital District Organization, Colorado City, TX 5% Or Greater Direct Ownership Interest Jan 1, 1967 100%
Operational/Managerial Control Dec 30, 2024
Adp of the SNF Jan 14, 2025
Donna Goebel Individual Corporate DirectorBoard Member Oct 29, 2024

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Mitchell County Hospital DistrictColorado City, TX, CCN 451342 Hospital Operational/Managerial Control Sep 1, 2010
Mitchell County Hospital DistrictColorado City, TX, CCN 45Z342 Hospital Operational/Managerial Control Sep 1, 2010
Family Medical AssociatesColorado City, TX, CCN 453403 Rural health clinic Operational/Managerial Control (100%) Jan 1, 1992

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

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

Affiliated clinicians 3

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": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1306832092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 W INTERSTATE 20",
            "city": "COLORADO CITY",
            "state": "TX",
            "postal_code": "795122685",
            "telephone_number": "325-728-5247",
            "fax_number": "325-728-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 W INTERSTATE 20",
            "city": "COLORADO CITY",
            "state": "TX",
            "postal_code": "795122685",
            "telephone_number": "325-728-5247",
            "fax_number": "325-728-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITCHELL COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MITCHELL COUNTY HOSPITAL",
        "enumeration_date": "2005-09-27",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A",
        "authorized_official_last_name": "GAFFORD",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "325-728-3431"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "142095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000422101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mitchell County Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mitchell County Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colorado City, TX

Sources for this page

Verify at the official NPI Registry.