NPIMap

Organization Active NPI

Preferred Hospital Leasing Hemphill, Inc

Doing business as West Sabine Community Clinic

  • Rural Health Clinic/Center
  • Pineland, TX
National Provider Identifier
1548038896
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
PREFERRED HOSPITAL LEASING HEMPHILL, INC
Doing business as
West Sabine Community Clinic
Practice address
109 Timberland Hwy
Pineland, TX 75968-4012
Phone
(409) 217-3900
Fax
(409) 584-2210
NPI assigned
Dec 15, 2023
Last updated
Feb 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Authorized official

Name
Donald A Freeman
Title
Owner/President
Phone
(405) 878-0202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

109 Timberland Hwy
Pineland, TX 75968-4012

Mailing address

PO Box 245
Pineland, TX 75968-0245

Other names 1

  • West Sabine Community 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
O20090106000543 TX Part B Supplier - Clinic/Group Practice 1759467111 Receives reassigned benefits from 30 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hemphill, TX; Pineland, TX
O20240119002600 TX Part A Provider - Rural Health Clinic 1759467111 Practice locations: Pineland, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1548038896. Details of each certification follow.

Rural health clinic certification: CCN 678568

Legal name
PREFERRED HOSPITAL LEASING HEMPHILL, INC.
Doing business as
WEST SABINE COMMUNITY CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 8, 2024
Last certification
Aug 8, 2024
Ownership / control type
1B
Organization structure
OtherProprietary
Incorporated
Feb 12, 2008 in OK
Enrollment address
109 W Timberland Hwy
Pineland, TX 75968-4012
Related CCNs
451361

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

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Preferred Hospital Leasing Hemphill Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

2301 Worth St
Hemphill, TX 75948

2421 Worth St
Hemphill, TX 75948
Phone (409) 787-1416

109 Timberland Hwy
Pineland, TX 75968
Phone (409) 217-3900

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Donald a Freeman Individual 5% Or Greater Direct Ownership InterestOwner/President Feb 12, 2024 100%
Preferred Management Corporation Organization, Shawnee, OK For-profit, Chain home office Operational/Managerial Control Feb 12, 2024
Kaylee McDaniel Individual W-2 Managing EmployeeAdministrator Feb 12, 2024
Karla a Betterton Individual Corporate OfficerVice President of Finance Feb 12, 2024
Jared Chanski Individual Corporate OfficerExecutive Vice President Feb 12, 2024
Josh Tucker Individual Corporate OfficerChief Financial Officer Feb 12, 2024

Facilities with the same owner 35

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

View all 35

Practitioners & affiliated clinicians

Practitioners 31

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 31

NPI Registry JSON

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

{
    "created_epoch": "1702598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1548038896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 245",
            "city": "PINELAND",
            "state": "TX",
            "postal_code": "759680245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 TIMBERLAND HWY",
            "city": "PINELAND",
            "state": "TX",
            "postal_code": "759684012",
            "telephone_number": "409-217-3900",
            "fax_number": "409-584-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED HOSPITAL LEASING HEMPHILL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-15",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "405-878-0202"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Sabine Community Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "West Sabine Community Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pineland, TX

Sources for this page

Verify at the official NPI Registry.