NPIMap

Organization Active NPI

Jack County Hospital District

Doing business as Avir at Jacksboro

  • Skilled Nursing Facility
  • Jacksboro, TX
National Provider Identifier
1396798583
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
JACK COUNTY HOSPITAL DISTRICT
Doing business as
Avir at Jacksboro
Practice address
211 E Jasper St
Jacksboro, TX 76458-1848
Phone
(940) 567-2686
Fax
(940) 567-5038
NPI assigned
May 18, 2006
Last updated
Mar 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Authorized official

Name
Mr. Frank Beaman
Title
Ceo
Phone
(940) 567-6633

Specialties & licenses 1

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

Addresses

Primary practice location

211 E Jasper St
Jacksboro, TX 76458-1848

Mailing address

211 E Jasper St
Jacksboro, TX 76458-1848

Other identifiers 1

IdentifierTypeStateIssuer
004888OtherTXFACILITY ID NO.

Other names 1

  • Avir at Jacksboro Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141031001782 TX Part A Provider - Skilled Nursing Facility 4587842315 Practice locations: Jacksboro, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396798583. Details of each certification follow.

Skilled nursing facility certification: CCN 455808

Legal name
JACK COUNTY HOSPITAL DISTRICT
Doing business as
AVIR AT JACKSBORO
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Apr 20, 1989
Last certification
Oct 4, 2024
Beds
104
Ownership / control type
Corporation
Multi-facility organization
AVIR
Organization structure
GovernmentNon-profit
Enrollment address
211 E Jasper St
Jacksboro, TX 76458-1848
Nursing home name
AVIR AT JACKSBORO
Affiliated entity
AVIR HEALTH GROUP

Other NPIs with the same Medicare PAC ID 6

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Avir at JacksboroCCN 455808 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Apr 20, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10453.1 residents per day on average
Chain
Avir Health Group116 facilities in the chain
Penalties (3 years)
1Fines totaling $23,813

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Faith Community Hosp14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

211 E Jasper St
Jacksboro, TX 76458
Phone (940) 567-2686

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Jacey L Brittain Individual Operational/Managerial Control Jun 12, 2023
Adp of the SNF Jun 12, 2023
Jack County Hospital District Organization, Jacksboro, TX 5% Or Greater Direct Ownership Interest Sep 30, 2014 100%
Welltower NNN Group, LLC Organization, Toledo, OH LLC, Owned by another organization or individual 5% Or Greater Mortgage Interest Mar 1, 2025 100%
Adp of the SNF Mar 1, 2025
Kim Lee Individual Corporate DirectorChief Financial Officer Jan 1, 2022
Frank L Beaman Individual Corporate DirectorCeo Jan 1, 2008
Managing Control - Governing BodyCeo Sep 30, 2014
THCM, LLC Organization, Fort Worth, TX Operational/Managerial Control Jan 1, 2018 100%
Welltower Op, LLC Organization, Toledo, OH LLC, Owned by another organization or individual 5% Or Greater Mortgage Interest Mar 1, 2025 100%
Adp of the SNF Mar 1, 2025
Syed M a Jamal Individual Operational/Managerial Control Mar 1, 2025
Adp of the SNF Mar 1, 2025
211 E Jasper Street Property Owner LLC Organization, Toledo, OH LLC, Owned by another organization or individual 5% Or Greater Mortgage Interest Mar 1, 2025 100%
Adp of the SNF Mar 1, 2025
211 E Jasper Street Opco LLC Organization, Jackson, NJ LLC Operational/Managerial Control Mar 1, 2025
Adp of the SNF Apr 2, 2025
Welltower Inc Organization, Toledo, OH Corporation, Real estate investment trust (REIT) 5% Or Greater Security Interest Mar 1, 2025 100%
Adp of the SNF Mar 1, 2025
Jacksboro Nursing Operations, LLC Organization, Fort Worth, TX Operational/Managerial Control Jan 1, 2018 100%

Owners & managing parties with NPI records 3

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

Facilities with the same owner 8

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

Practitioners & affiliated clinicians

Practitioners 3

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 1

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": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741305600000",
    "number": "1396798583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E JASPER ST",
            "city": "JACKSBORO",
            "state": "TX",
            "postal_code": "764581848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E JASPER ST",
            "city": "JACKSBORO",
            "state": "TX",
            "postal_code": "764581848",
            "telephone_number": "940-567-2686",
            "fax_number": "940-567-5038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A",
        "authorized_official_last_name": "BEAMAN",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "940-567-6633",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY ID NO.",
            "identifier": "004888",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avir at Jacksboro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksboro, TX

Sources for this page

Verify at the official NPI Registry.