Quitman Hospital LLC
Organization Active NPI Critical Access Hospital · Quitman, TX
NPI 1477061885 · NPPES record last updated Oct 1, 2023
Key facts
- NPI
- 1477061885
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- Legal business name
- QUITMAN HOSPITAL LLC
- Practice address
- 117 N Winnsboro St
Quitman, TX 75783-2144 - Phone
- (903) 763-6300
- NPI assigned
- Jan 19, 2018
- Organization subpart
- Yes
- Parent organization (as reported)
- AHS EAST TEXAS HEALTH SYSTEM, LLC
Authorized official
- Name
- Stephen C Petrovich
- Title
- Evp and Secretary
- Phone
- (615) 296-3000
Other NPIs on the same Medicare enrollment 3
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 6
Related certifications (CCN) 4
Facilities with the same owner 61
Practitioners 45
-
Craig McMullen, M.D.
-
Joe Gilbert Valdez Jr., M.D.
-
Darcie A Baker, PA C
-
Robert Van Blair, MD
-
Waleed Chaudhary, MD
-
Paula Jean Dibenedetto, ARNP
-
Chelsea Emmert, NP
-
Christian Ferrer, MD
-
Hope Hardy, DO
-
Thomas F McCloskey, DPM
-
Sarah McCutcheon, APRN, FNP-C
-
Augustine Njoku, M.D.
-
Gaurav Patel, M.D.
-
Shannon E Phillips Jr., N.P.
-
Enrique C Quiambao, FNP-C
-
Eric D Reed, D.O.
-
Terry Sampson, NP
Affiliated clinicians 73
-
Aderemi Adewuyi, M.D.
-
Muhammad Almas, MD
-
Darcie A Baker, PA C
-
Robert Van Blair, MD
-
Kimberly Brown, FNP
-
Bruce C Carter, M.D.
-
Kevin W Caton, CRNA
-
Waleed Chaudhary, MD
-
William Chace Conner, M.D.
-
Luis A Destarac, M.D.
-
Lauren Micah Doyle, FNP-C
-
Paul Driver, DO
-
Nicole A Duval, M.D.
-
Chelsea Emmert, NP
-
Christian Ferrer, MD
-
Niki Michelle Fincher, CRNA
-
Jennifer Flowers, FNP-BC
-
Kavitha Ganesan, M.D.
-
Maynard Shawn Gonter, PA-C
Medicare Care Compare: Hospital
- Listed as
- Ut Health East Texas Quitman Hospital
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Other
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in TX
Hospital certification: CCN 451380
- Legal name
- QUITMAN HOSPITAL LLC
- Doing business as
- UTHEALTH EAST TEXAS QUITMAN HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Feb 1, 2011
- Last certification
- Dec 31, 2025
- Beds
- 25
- Ownership / control type
- Other
- Most recent change of ownership
- Mar 1, 2018 (2 total)
- Organization structure
- LLC · Proprietary
- Incorporated
- Dec 19, 2017 in DE
- Enrollment address
- 117 N Winnsboro St
Quitman, TX 75783-2144
Hospital certification: CCN 45Z380
- Legal name
- QUITMAN HOSPITAL LLC
- Doing business as
- UT HEALTH EAST TEXAS QUITMAN HOSPITAL
- Organization structure
- LLC · Proprietary
- Incorporated
- Dec 19, 2017 in DE
- Enrollment address
- 117 N Winnsboro St
Quitman, TX 75783-2144
All disclosed owners & managing parties 15
| Name | Role | Since | Share |
|---|---|---|---|
| Ardent Health Inc |
5% Or Greater Indirect Ownership Interest | Mar 1, 2018 | 100% |
| Ahs Texas, LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2019 | 100% |
| 5% Or Greater Indirect Ownership Interest | Jan 1, 2021 | 100% | |
| Martin Bonick |
Corporate Officer |
Aug 19, 2020 | |
| Mary a Crabtree |
Corporate Officer |
Mar 1, 2018 | |
| Corporate Officer |
Mar 1, 2018 | ||
| Ahs Management Company Inc. |
Operational/Managerial Control | Mar 1, 2018 | |
| Stephen C Petrovich |
Corporate Officer | Mar 1, 2018 | |
| Corporate Officer |
Mar 1, 2018 | ||
| Ardent Legacy Holdings LLC |
5% Or Greater Indirect Ownership Interest | Mar 1, 2018 | 100% |
| Ahs East Texas Health System, LLC |
5% Or Greater Direct Ownership Interest | Mar 1, 2018 | 100% |
| Donald Baker |
Corporate Officer |
Nov 1, 2020 | 100% |
| W-2 Managing Employee |
Nov 1, 2020 | 100% | |
| Corporate Officer |
Sep 1, 2020 | 100% | |
| W-2 Managing Employee |
Sep 1, 2020 | 100% | |
| Ahp Health Partners, Inc |
5% Or Greater Indirect Ownership Interest | Mar 1, 2018 | 100% |
| Brian Walton |
Corporate Officer |
Mar 1, 2018 | |
| Carolyn Schneider |
Corporate Officer |
Aug 1, 2021 | |
| Terika Richardson Mbanu |
Corporate Officer |
Sep 1, 2021 | |
| James Grimes |
Corporate Officer |
Sep 1, 2021 | |
| Alfred Lumsdaine |
Corporate Officer |
Sep 1, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180517000264 | TX | Part B Supplier - Clinic/Group Practice | 9133484330 |
Receives reassigned benefits from 17 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Mineola, TX; Winnsboro, TX; Quitman, TX |
| O20180518000098 | TX | Part a Provider - Critical Access Hospital | 9133484330 | Practice locations: Quitman, TX |
| O20180813001620 | TX | Part a Provider - Critical Access Hospital | 9133484330 | Practice locations: Quitman, TX |
National Provider Directory
- Tax ID family
- Quitman Hospital LLC
Locations
406 E State Highway 243
Canton, TX 75103
Phone (903) 567-4784
606 E Goode St
Ste 400
Quitman, TX 75783
Phone (903) 763-4404
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | Yes |
Addresses
Primary practice location
117 N Winnsboro St
Quitman, TX 75783-2144
Mailing address
340 Seven Springs Way Ste 100
Brentwood, TN 37027-5697
Phone (615) 296-3000
Other providers in Quitman, TX
- Kristina R Pearson
- Quitman Health Services, PLLC
- Quitman Hometown Dental
- Quitman Hospital LLC
- Quitman Hospital LLC
- Quitman Hospital LLC
- Quitman Isd
- Quitman Nursing and Rehab Center, LLC
- Quitman Therapy and Rehabilitation
- Reflections Hospice of Texas LLC
All providers in Quitman, TX · Critical Access Hospital in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2023. 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.