Jackson County Hospital District
Organization Active NPI Rural Health Clinic/Center · Ganado, TX
NPI 1679445654 · NPPES record last updated Sep 19, 2025
Key facts
- NPI
- 1679445654
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- JACKSON COUNTY HOSPITAL DISTRICT
- Practice address
- 204 S 4TH
Ganado, TX 77962-2105 - Phone
- (361) 771-3331
- NPI assigned
- Sep 19, 2025
- Organization subpart
- No
Authorized official
- Name
- Mr. Lance Harrison Smiga
- Title
- Chief Executive Officer
- Phone
- (361) 235-2982
Owners & managing parties with NPI records 6
Owned or controlled facilities with NPI records 4
Other NPIs with the same Medicare PAC ID 6
Related certifications (CCN) 1
Facilities with the same owner 4
Practitioners 105
-
Yasir Ahmed, M.D.
-
Stephanie Cunningham, FNP-C
-
Deke Steven Eberhard, M.D.
-
Ashley Nicole Harris, FNP-C
-
Asif Amin Kabani, MD
-
Stephanie Kay Laskowski, FNP-C
-
Ruben Lerma, MD
-
Cesar Alfredo Maldonado, M.D.
-
Anthony B McDowell, M.D.
-
Ramy Noche, M.D.
-
Sophia Siddiqi, M.D.
-
Ronald D. Kosanke, PA-C
-
Jared D Nielson, FNP-C
-
Aaron Adamson, DO
-
Ismail Olayinka Adesanya, M.D.
-
Kamran Algilani, M.D.
-
George Yerby Alsop Jr., M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D0911815 | Jackson County Medical Clinic of Ganado | Certificate of waiver | Nov 30, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Rural health clinic certification: CCN 673495
- Legal name
- JACKSON COUNTY HOSPITAL DISTRICT
- Doing business as
- JACKSON COUNTY MEDICAL CLINIC OF GANADO
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Mar 5, 2021
- Last certification
- Jan 4, 2024
- Ownership / control type
- Non-profit – church related
- Most recent change of ownership
- Oct 1, 2025 (1 total)
- Organization structure
- Government · Non-profit
- Enrollment address
- 204 S 4TH
Ganado, TX 77962-2105 - Related CCNs
- 451363
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Chris Lundstrom |
Corporate Officer |
Oct 22, 2020 | |
| Janet Chanek |
Corporate Officer |
Dec 20, 2011 | |
| Debbie Schneider |
Corporate Officer |
Jan 26, 2023 | |
| Jim Kaelin |
Corporate Officer |
Jun 29, 2020 | |
| Jackson County Hospital District |
Operational/Managerial Control | Oct 1, 2025 | |
| Dustin Hicks |
Corporate Officer |
Apr 24, 2025 | |
| Tammy Gendke |
Corporate Officer |
Aug 23, 2018 | |
| Lance Smiga |
Corporate Director |
Jan 1, 2025 | |
| Jamie Stuhrenberg |
Corporate Officer |
May 23, 2024 | |
| Mindy Curlee |
Corporate Director |
Jan 1, 2025 | |
| W-2 Managing Employee |
Jan 1, 2025 | ||
| Jimmy Lopez |
Corporate Officer |
May 12, 2010 | |
| David Darilek |
Corporate Officer |
Dec 13, 2012 |
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Jackson Healthcare Center |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2005 |
| Jackson Healthcare Center |
Hospital | 5% Or Greater Direct Ownership Interest | Jan 1, 2005 |
| Jackson County Home Health |
Home health agency | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Oct 31, 2011 Oct 31, 2011 |
| Jackson County Medical Clinic of Edna |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2005 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20251218001109 | TX | Part a Provider - Rural Health Clinic | 2365423795 | Practice locations: Ganado, TX |
National Provider Directory
Locations
1013 S Wells St
#B
Edna, TX 77957
Phone (361) 782-7800
107 E Rogers St
Ganado, TX 77962
Phone (361) 771-3315
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
204 S 4TH
Ganado, TX 77962-2105
Mailing address
204 S 4TH
Ganado, TX 77962-2105
Phone (361) 771-3331
Other names
- Jackson County Medical Clinic of Ganado
Other providers in Ganado, TX
- Ganado Nursing and Rehabilitation Center. LLC
- Jackson County Hospital District
- Jackson County Hospital District
- Jackson County Hospital District
- Jackson County Hospital District
- Ronald D. Kosanke
- Bruce A. Ramsey
- Anibal G Scuadroni Jr.
- Lara Dupre Sudik
- Chelsey Dawn Taylor
All providers in Ganado, 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 Sep 19, 2025. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.