NPIMap

Organization Active NPI

Haskell County Hospital

Doing business as Haskell Memorial Hospital Clinic

  • Clinic/Center
  • Haskell, TX
National Provider Identifier
1396175683
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
HASKELL COUNTY HOSPITAL
Doing business as
Haskell Memorial Hospital Clinic
Practice address
1400 S 1St St
Haskell, TX 79521-5426
Phone
(940) 864-8513
Fax
(940) 864-2779
NPI assigned
Nov 22, 2013
Last updated
Nov 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Authorized official

Name
Sydney Saucedo
Title
Clinic Manager
Phone
(940) 228-0612

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1400 S 1St St
Haskell, TX 79521-5426

Mailing address

1400 S 1St St
Haskell, TX 79521-5426
Phone (940) 228-0612

Other names 1

  • HASKELL MEMORIAL HOSPITAL CLINIC Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070702000050 TX Part B Supplier - Hospital Department(S) 1355440413 Receives reassigned benefits from 28 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Haskell, TX
O20101014000198 TX Part A Provider - Critical Access Hospital 1355440413 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Haskell, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396175683. Details of each certification follow.

Hospital certification: CCN 451341

Legal name
HASKELL COUNTY HOSPITAL
Doing business as
HASKELL MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jun 1, 2003
Last certification
Apr 20, 2016
Beds
25
Ownership / control type
Hospital district or authority
Organization structure
GovernmentNon-profit
Enrollment address
1 Avenue N
Haskell, TX 79521-5414
Other Hospital Practice Location

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Haskell Memorial HospitalCCN 451341 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

1400 S 1st St
Haskell, TX 79521
Phone (940) 228-0612

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
Haskell County Hospital Organization, Haskell, TX Operational/Managerial Control Sep 23, 2010
Michelle Stevens Individual Corporate DirectorCeo Mar 1, 2021
W-2 Managing Employee Mar 1, 2021

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 15

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 15

Affiliated clinicians 70

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 70

NPI Registry JSON

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669075200000",
    "number": "1396175683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S 1ST ST",
            "city": "HASKELL",
            "state": "TX",
            "postal_code": "795215426",
            "telephone_number": "940-228-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S 1ST ST",
            "city": "HASKELL",
            "state": "TX",
            "postal_code": "795215426",
            "telephone_number": "940-864-8513",
            "fax_number": "940-864-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HASKELL COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-22",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A",
        "authorized_official_last_name": "SAUCEDO",
        "authorized_official_first_name": "SYDNEY",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "940-228-0612"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HASKELL MEMORIAL HOSPITAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HASKELL MEMORIAL HOSPITAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Haskell, TX

Sources for this page

Verify at the official NPI Registry.