Goodall-Witcher Hospital Authority

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

GOODALL-WITCHER HOSPITAL AUTHORITY

Doing business as

Lake Whitney Medical Clinic

Practice address

202 E Jefferson Ave
Whitney, TX 76692-2398

Phone

(254) 694-2221

Fax

(254) 694-9978

NPI assigned

Nov 20, 2014

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adam B Willmann

Title

President/Ceo

Phone

(254) 675-8322

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Lake Whitney Medical Clinic Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Change-of-ownership history 1

Change of ownership 1

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

• Bosque County Hospital District

  dba Goodall-Witcher Clinic in Whitney

  • Rural Health Clinic/Center
  • Whitney, TX
  • NPI 1720540255

  Sold to, 2019-07-01

  CMS change of ownership

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

{
    "created_epoch": "1416441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1336546266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E JEFFERSON AVE",
            "city": "WHITNEY",
            "state": "TX",
            "postal_code": "766922398",
            "telephone_number": "254-674-2221",
            "fax_number": "254-694-9978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E JEFFERSON AVE",
            "city": "WHITNEY",
            "state": "TX",
            "postal_code": "766922398",
            "telephone_number": "254-694-2221",
            "fax_number": "254-694-9978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODALL-WITCHER HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-20",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WILLMANN",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "254-675-8322"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "347012203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Whitney Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Family of Park Plaza, L.L.C. (Park Plaza Nursing Home)
• Frontier Hospitals, Inc. (Lake Whitney Medical Center)
• Gates of Hope
• Courtney Faye Glaesmann
• Jordan Gobert
• Jerry Leon Gribble, BA MPH DDS
• Healthnow Urgent Care Inc
• Randall Dale Henderson, DO
• Kaci L Henson
• Hospice of the Heart, Inc.

• Rural Health Clinic/Center in Whitney, TX
• Providers in Whitney, TX by specialty
• Rural Health Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.