NPIMap

Organization Active NPI

Karnes County Hospital District

Doing business as Kaiser Family Practice

  • Rural Health Clinic/Center
  • Kenedy, TX
National Provider Identifier
1669930418
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
KARNES COUNTY HOSPITAL DISTRICT
Doing business as
Kaiser Family Practice
Practice address
3349 S Highway 181 Ste 3
Kenedy, TX 78119-5268
Phone
(830) 583-3401
NPI assigned
Mar 11, 2019
Last updated
May 20, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
KARNES COUNTY HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Authorized official

Name
Beverly J Montez
Title
Director of Business Office
Phone
(830) 583-4502

Specialties & licenses 1

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

Addresses

Primary practice location

3349 S Highway 181 Ste 3
Kenedy, TX 78119-5268

Mailing address

3349 S Highway 181
Kenedy, TX 78119-5247
Phone (830) 583-3402

Other names 1

  • Kaiser Family Practice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200123001693 TX Part A Provider - Rural Health Clinic 5496740201 Practice locations: Kenedy, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669930418. Details of each certification follow.

Rural health clinic certification: CCN 673483

Legal name
KARNES COUNTY HOSPITAL DISTRICT
Doing business as
KAISER FAMILIY PRACTICE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 11, 2020
Last certification
May 28, 2026
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Incorporated
Apr 1, 2019 in TX
Enrollment address
3349 S Highway 181
Kenedy, TX 78119-5247
Related CCNs
451364

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).

National Provider Directory

National Provider Directory
Part of
Karnes County Hospital District

Locations

3349 S Highway 181
Ste 3
Kenedy, TX 78119
Phone (830) 583-3900

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Beverly Montez Individual W-2 Managing EmployeeDirector of Business Office Jan 1, 2020
David Lee Individual Corporate OfficerCeo Oct 30, 2012
W-2 Managing EmployeeCeo Oct 30, 2012

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Otto Kaiser Memorial HospitalKenedy, TX, CCN 451364 Hospital Operational/Managerial Control (100%) Oct 30, 2012
Otto Kaiser Memorial HospitalKenedy, TX, CCN 45Z364 Hospital Operational/Managerial Control Sep 7, 2010
Kaiser Home Health ServicesKenedy, TX, CCN 459424 Home health agency 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2011

Owned or controlled facilities with NPI records 2

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

NPI Registry JSON

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1669930418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3349 S HIGHWAY 181",
            "city": "KENEDY",
            "state": "TX",
            "postal_code": "781195247",
            "telephone_number": "830-583-3402",
            "fax_number": "830-583-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3349 S HIGHWAY 181 STE 3",
            "city": "KENEDY",
            "state": "TX",
            "postal_code": "781195268",
            "telephone_number": "830-583-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KARNES COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KARNES COUNTY HOSPITAL DISTRICT",
        "enumeration_date": "2019-03-11",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "MONTEZ",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS OFFICE",
        "authorized_official_telephone_number": "830-583-4502"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kaiser Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kenedy, TX

Sources for this page

Verify at the official NPI Registry.