NPIMap

Organization Active NPI

Fisher County Hospital District

  • Medicare Defined Swing Bed Hospital Unit
  • Rotan, TX
National Provider Identifier
1306969431
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
000355 Issued in TX
Legal business name
FISHER COUNTY HOSPITAL DISTRICT
Practice address
774 State Highway 70 N
Rotan, TX 79546-6918
Phone
(325) 735-2256
Fax
(325) 735-3070
NPI assigned
Apr 6, 2007
Last updated
Oct 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Authorized official

Name
Mrs. Carey Leanne Martinez
Title
Ceo
Phone
(325) 735-2256

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 000355 TX Primary

Addresses

Primary practice location

774 State Highway 70 N
Rotan, TX 79546-6918

Mailing address

PO Box F
Rotan, TX 79546-0485
Phone (325) 735-2256

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100908001115 TX Part A Provider - Critical Access Hospital 2163311465 Practice locations: Rotan, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306969431. Details of each certification follow.

Hospital certification: CCN 45Z313

Legal name
FISHER COUNTY HOSPITAL DISTRICT
Organization structure
OtherNon-profit
Enrollment address
774 State Highway 70 N
Rotan, TX 79546-6918
Hospital Swing-Bed Unit

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).

National Provider Directory

National Provider Directory
Tax ID family
Fisher County Hospital District9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Carey Leanne Martinez Individual Corporate DirectorCeo Nov 1, 2017
W-2 Managing EmployeeCeo Nov 1, 2017
Caleb White Individual Corporate OfficerCfo Jan 1, 2022
W-2 Managing EmployeeCfo Jan 1, 2022

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Clearfork Health CenterRotan, TX, CCN 458779 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 20, 1998

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 1

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 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": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444780800000",
    "number": "1306969431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX F",
            "city": "ROTAN",
            "state": "TX",
            "postal_code": "795460485",
            "telephone_number": "325-735-2256",
            "fax_number": "325-735-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "774 STATE HIGHWAY 70 N",
            "city": "ROTAN",
            "state": "TX",
            "postal_code": "795466918",
            "telephone_number": "325-735-2256",
            "fax_number": "325-735-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FISHER COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2015-10-14",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "CAREY",
        "authorized_official_middle_name": "LEANNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "325-735-2256",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "TX",
            "license": "000355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rotan, TX

Sources for this page

Verify at the official NPI Registry.