GPCH, LLC
Organization Active NPI Rural Health Clinic/Center · Fritch, TX
NPI 1689872020 · NPPES record last updated Aug 7, 2024
Key facts
- NPI
- 1689872020
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- License
- 008574 (TX)
- Legal business name
- GPCH, LLC
- Practice address
- 700 W Broadway St
Fritch, TX 79036-8754 - Phone
- (806) 857-2311
- NPI assigned
- Jul 6, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Donald Earl Bates Jr.
- Title
- Ceo
- Phone
- (806) 467-5700
Other NPIs on the same Medicare enrollment 9
Other NPIs with the same Medicare PAC ID 4
Related certifications (CCN) 2
Facilities with the same owner 4
Practitioners 18
-
Tristen Baylee West, APRN, FNP-C
-
Leticia R. Chavez, RN,FNP,BC
-
Martha E Flores, N.P.
-
Joshua D North, MD
-
Callie Shane Rhoton, M.D.
-
James Avery Rush IV, M.D.
-
Stephen Donald Scoggin, M.D.
-
Helen Melissa Strope, NP-C
-
Walter L Gadberry, M. D.
-
Wilson Alan Cochrane, PA-C
-
Brandi Michelle Cooper, FNP-C
-
Teri Y Alberty, CRNA
-
Erica L Cole, CRNA
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D0930133 | Fritch Medical Clinic | Certificate of waiver | Jun 15, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX
Rural health clinic certification: CCN 458778
- Legal name
- GPCH LLC
- Doing business as
- FRITCH MEDICAL CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Oct 13, 1997
- Last certification
- Oct 19, 2022
- Ownership / control type
- 1B
- Organization structure
- LLC · Proprietary
- Incorporated
- Jun 5, 2007 in TX
- Enrollment address
- 700 W Broadway St
Fritch, TX 79036-8754 - Related CCNs
- 451369
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Dina K Hermes |
Corporate Officer |
Sep 11, 2011 | |
| Operational/Managerial Control |
Sep 11, 2011 | ||
| Audrey Schroeder |
Corporate Officer |
Oct 26, 2016 | |
| Hutchinson County EMS Inc |
5% Or Greater Direct Ownership Interest | Jan 2, 2023 | 100% |
| Operational/Managerial Control | Jan 2, 2023 | 100% | |
| Donald E Bates |
Corporate Officer |
Feb 8, 2016 | |
| Operational/Managerial Control |
Feb 8, 2016 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071214000640 | TX | Part a Provider - Rural Health Clinic | 0042303232 | Practice locations: Fritch, TX |
| O20090311000280 | TX | Part B Supplier - Clinic/Group Practice | 0042303232 |
Receives reassigned benefits from 37 practitioners 12 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Borger, TX; Fritch, TX; Missouri City, TX |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | 008574 | TX | Yes |
Addresses
Primary practice location
700 W Broadway St
Fritch, TX 79036-8754
Mailing address
100 Medical Dr
Borger, TX 79007-7579
Phone (806) 467-5701
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1930042-01 | Medicaid | TX |
Other names
- Fritch Medical Clinic
Other providers in Fritch, TX
- City of Fritch
- Fritch Dental Group, PLLC
- Fritch Drug & Gift Shoppe Inc
- Scott S Gordon
- Ashton Allen Hall
- William Kelly Henderson
- Kathy Lindsey
- Timothy Dylan Standiford
- Dane Welch
All providers in Fritch, 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 Aug 7, 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.
- 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.