NPIMap

Organization Active NPI

County of Throckmorton

Doing business as Avir at Graham

  • Skilled Nursing Facility
  • Graham, TX
National Provider Identifier
1629021803
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
COUNTY OF THROCKMORTON
Doing business as
Avir at Graham
Garden Terrace Healthcare Center
Practice address
1224 Corvadura St
Graham, TX 76450-4355
Phone
(940) 549-4646
Fax
(940) 549-8006
NPI assigned
May 18, 2006
Last updated
Aug 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Authorized official

Name
Kirby Gober
Title
Ceo
Phone
(940) 849-2141

Specialties & licenses 1

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

Addresses

Primary practice location

1224 Corvadura St
Graham, TX 76450-4355

Mailing address

1224 Corvadura St
Graham, TX 76450-4355

Other identifiers 2

IdentifierTypeStateIssuer
001026248MedicaidTX
004896OtherTXFACILITY ID NO.

Other names 2

  • Avir at Graham Doing business as
  • Garden Terrace Healthcare Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141124001750 TX Part A Provider - Skilled Nursing Facility 6305067539 Practice locations: Graham, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629021803. Details of each certification follow.

Skilled nursing facility certification: CCN 455555

Legal name
COUNTY OF THROCKMORTON
Doing business as
AVIR AT GRAHAM
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Oct 1, 1985
Last certification
Jul 20, 2024
Beds
116
Ownership / control type
Hospital District
Organization structure
OtherNon-profit
Enrollment address
1224 Corvadura St
Graham, TX 76450-4355
Nursing home name
AVIR AT GRAHAM
Affiliated entity
AVIR HEALTH GROUP

Other NPIs with the same Medicare PAC ID 3

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 GrahamCCN 455555 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Government - Hospital district
Certified
Oct 1, 1985
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11640.2 residents per day on average
Chain
Avir Health Group116 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0679098County of Throckmorton1224 Corvadura St, Graham, TX 76450Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
County of Throckmorton4 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.

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
1224 Corvadura St Property Owner LLC Organization, Toledo, OH LLC Adp of the SNF Oct 1, 2025
Welltower Op LLC Organization, Toledo, OH LLC Adp of the SNF Oct 1, 2025
Kirby Gober Individual Corporate OfficerCeo Nov 1, 2014
Nochum Freund Individual Operational/Managerial Control Oct 1, 2025
Shirl Anne Manuel Individual Adp of the SNF Apr 17, 2023
Aaron Travitsky Individual Operational/Managerial Control Oct 1, 2025
Christopher Ryan Easterling Individual Adp of the SNF Oct 1, 2025
Welltower NNN Group, LLC Organization, Toledo, OH LLC Adp of the SNF Oct 1, 2025
County of Throckmorton Organization, Throckmorton, TX 5% Or Greater Direct Ownership Interest Nov 1, 2014 100%
Welltower Op, LLC Organization, Toledo, OH LLC Adp of the SNF Oct 1, 2025
Welltower Inc Organization, Toledo, OH Real estate investment trust (REIT) Adp of the SNF Oct 1, 2025
1224 Corvadura St Opco LLC Organization, Jackson, NJ LLC Operational/Managerial Control Oct 1, 2025
Adp of the SNF Feb 2, 2026

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Avir at HaskellHaskell, TX, CCN 675014 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 30, 2014
Graham Oaks Care CenterGraham, TX, CCN 455968 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2022
Avir at GainesvilleGainesville, TX, CCN 675067 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 1

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 4

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": "1787184000000",
    "number": "1629021803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 CORVADURA ST",
            "city": "GRAHAM",
            "state": "TX",
            "postal_code": "764504355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 CORVADURA ST",
            "city": "GRAHAM",
            "state": "TX",
            "postal_code": "764504355",
            "telephone_number": "940-549-4646",
            "fax_number": "940-549-8006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF THROCKMORTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A",
        "authorized_official_last_name": "GOBER",
        "authorized_official_first_name": "KIRBY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "940-849-2141"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001026248",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY ID NO.",
            "identifier": "004896",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avir at Graham",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Garden Terrace Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Graham, TX

Sources for this page

Verify at the official NPI Registry.