Karnes County Hospital District
Organization Active NPI Rural Health Clinic/Center · Kenedy, TX
NPI 1669930418 · NPPES record last updated May 20, 2024
Key facts
- NPI
- 1669930418
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- KARNES COUNTY HOSPITAL DISTRICT
- Practice address
- 3349 S Highway 181 Ste 3
Kenedy, TX 78119-5268 - Phone
- (830) 583-3401
- NPI assigned
- Mar 11, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- KARNES COUNTY HOSPITAL DISTRICT
Authorized official
- Name
- Beverly J Montez
- Title
- Director of Business Office
- Phone
- (830) 583-4502
Owned or controlled facilities with NPI records 2
Other NPIs with the same Medicare PAC ID 3
Related certifications (CCN) 1
Practitioners 3
-
Pamela Dawn Clark, FNP
-
Jochelle Pawelek Uriegas, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
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
- Other · Non-profit
- Incorporated
- Apr 1, 2019 in TX
- Enrollment address
- 3349 S Highway 181
Kenedy, TX 78119-5247 - Related CCNs
- 451364
All disclosed owners & managing parties 2
| Name | Role | Since | Share |
|---|---|---|---|
| Beverly Montez |
W-2 Managing Employee |
Jan 1, 2020 | |
| David Lee |
Corporate Officer |
Oct 30, 2012 | |
| W-2 Managing Employee |
Oct 30, 2012 |
All facility ownership & control disclosures 3
| Facility | Type | Role | Since |
|---|---|---|---|
| Otto Kaiser Memorial Hospital |
Hospital | Operational/Managerial Control (100%) | Oct 30, 2012 |
| Otto Kaiser Memorial Hospital |
Hospital | Operational/Managerial Control | Sep 7, 2010 |
| Kaiser Home Health Services |
Home health agency | 5% Or Greater Direct Ownership Interest (100%) | Sep 1, 2011 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200123001693 | TX | Part a Provider - Rural Health Clinic | 5496740201 | Practice locations: Kenedy, TX |
National Provider Directory
- Part of
- Otto Kaiser Memorial Ho
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
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
- Kaiser Family Practice
Other providers in Kenedy, TX
- Alyssa Monique Hinojosa
- Karnes County Adult Day Care, Inc.
- Karnes County Hospital District
- Karnes County Hospital District
- Karnes County Hospital District
- Karnes County Hospital District
- Karnes County Treasurer
- Kenedy Back and Neck Clinic
- Kenedy Dental PLLC
- Kenedy I Enterprises, LLC
All providers in Kenedy, TX · Rural Health Clinic/Center in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2024. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.