Jasper Hospital District

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

JASPER HOSPITAL DISTRICT

Practice address

2427 Sam Rayburn Pkwy
Brookeland, TX 75931-6408

Phone

(409) 489-4220

NPI assigned

Aug 22, 2024

Last updated

Jan 29, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Richard D Pham, MDNPI 1245282938

Title

Medical Director

Phone

(409) 489-4220

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1578396859. Details of each certification follow.

• CCN 678959 Rural health clinic · Active · Details

Rural health clinic certification: CCN 678959

Legal name

JASPER HOSPITAL DISTRICT

Doing business as

TOTAL CARE AT THE LAKE

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Dec 30, 2025

Last certification

Dec 30, 2025

Ownership / control type

Non-profit – church related

Organization structure

GovernmentProprietary

Enrollment address

2427 Sam Rayburn Pkwy
Brookeland, TX 75931-6408

Other NPIs with the same Medicare PAC ID 1

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

• Jasper Hospital District

  • Rural Health Clinic/Center
  • Jasper, TX
  • NPI 1457184798

  1658899653

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

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

• Jasper Hospital District

  • Rural Health Clinic/Center
  • Jasper, TX
  • NPI 1457184798

  O20250514000421

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 1

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

Owners & managing parties with NPI records 1

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

• Richard D Pham, MD

  • Family Medicine Physician
  • Jasper, TX
  • NPI 1245282938

  W-2 Managing Employee

  CMS ownership

Practitioners 4

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.

• Richard D Pham, MD

  • Family Medicine Physician
  • Jasper, TX
  • NPI 1245282938
  NPD Authorized official
• Chris Hue Gilchriest Jr., FNP-C

  • Family Nurse Practitioner
  • Jasper, TX
  • NPI 1689111460
  NPD
• Nina Martindale, APRN

  • Family Nurse Practitioner
  • Jasper, TX
  • NPI 1336687383
  NPD
• Rhonda Tyson

  • Registered Nurse
  • Jasper, TX
  • NPI 1457267577
  NPD (past)

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

{
    "created_epoch": "1724284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769644800000",
    "number": "1578396859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 878",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757100878",
            "telephone_number": "716-389-3279",
            "fax_number": "716-639-1382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2427 SAM RAYBURN PKWY",
            "city": "BROOKELAND",
            "state": "TX",
            "postal_code": "759316408",
            "telephone_number": "409-489-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASPER HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-22",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "409-489-4220",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madeline Grace Clark
• Complete Healthcare Services RHC PLLC (Complete Healthcare Services RHC - Rayburn)
• Kennedy Renee Goates, LVN
• Jasper Dental Emporium (Rayburn General Dentistry)
• Jasper Dental Emporium (Rayburn General Dentistry)
• Melanie Denise Kellam, PHD
• Monte O'Neal, DO
• John Joshua Seale, DDS
• Southern Nurses Inc. (Lakeside Lodge Assisted Living)
• Vivian Elaine Toland, LCSW

• Rural Health Clinic/Center in Brookeland, TX
• Providers in Brookeland, TX by specialty
• Rural Health Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.