Haskell County Hospital
Organization Active NPI Clinic/Center · Haskell, TX
NPI 1396175683 · NPPES record last updated Nov 22, 2022
Key facts
- NPI
- 1396175683
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- HASKELL COUNTY HOSPITAL
- Practice address
- 1400 S 1St St
Haskell, TX 79521-5426 - Phone
- (940) 864-8513
- Fax
- (940) 864-2779
- NPI assigned
- Nov 22, 2013
- Organization subpart
- No
Authorized official
- Name
- Sydney Saucedo
- Title
- Clinic Manager
- Phone
- (940) 228-0612
Owners & managing parties with NPI records 2
Other NPIs on the same Medicare enrollment 1
Related certifications (CCN) 2
Practitioners 16
-
Ahmad Ghassan Abazid, M.D
-
Dlinda G Benham, NP
-
Jamie Leann Benham, FNP
-
Sarah B Carter, MD
-
Jordan Elaine Earle, FNP
-
Kyle Kalra, DO
-
Cynthia H Moran, MD
-
Frank James Sheppard, M.D.
-
Stacy Renee Sims, FNP-C
-
Philip Jason Smith, FNP
-
Chad A Walters, PA-C
-
Joe Allen Yates, F.N.P.
-
Joseph Hassan Zadeh, D.O.
Affiliated clinicians 70
-
Mohammad Maher Al Sayyad, MD, FACP
-
Muzaffar Ali, MD, DO
-
Dustin Greg Allen, PA-C
-
Jon T Anderson, MD
-
Dlinda G Benham, NP
-
John Houston Bliznak, M.D.
-
Jeanne Kay Cason, FNP-BC
-
Amala Chacko, MD
-
Eric Chia-Wei Chen, PA-C
-
Shannon Eugene Cooke, M.D.
-
Milus Davis II, DO
-
Laura Dokupil, FNP-C
-
Ezekiel Lee Duke, M.D.
-
Michel D Dumas, M.D.
-
Trey Dennis Durdin, M.D.
-
Jordan Elaine Earle, FNP
-
Lee Ann Fraser, FNP-C
-
Brooklyn Gillit, FNP-C
Medicare Care Compare: Hospital
- Listed as
- Haskell Memorial Hospital
- Type
- Critical Access Hospitals
- Ownership
- Government - Hospital District or Authority
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX
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
- Government · Non-profit
- Enrollment address
- 1 Avenue N
Haskell, TX 79521-5414
All disclosed owners & managing parties 2
| Name | Role | Since | Share |
|---|---|---|---|
| Haskell County Hospital |
Operational/Managerial Control | Sep 23, 2010 | |
| Michelle Stevens |
Corporate Director |
Mar 1, 2021 | |
| W-2 Managing Employee | Mar 1, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
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
- HASKELL MEMORIAL HOSPITAL CLINIC
Other providers in Haskell, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.