NPIMap

Organization Active NPI

Booker Hospital District

Doing business as Teare Memorial Clinic

  • Rural Health Clinic/Center
  • Booker, TX
National Provider Identifier
1699844878
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
652675 Issued in TX
Legal business name
BOOKER HOSPITAL DISTRICT
Doing business as
Teare Memorial Clinic
Practice address
146 N Pioneer Drive
Booker, TX 79005-6008
Phone
(806) 658-4531
Fax
(806) 658-9344
NPI assigned
Nov 6, 2006
Last updated
Aug 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Authorized official

Name
Lisa Brown, APRN, FNPNPI 1275194169
Title
Aprn/Administrator
Phone
(806) 658-4531

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Rural Health Clinic/Center 261QR1300X 652675 TX Primary

Addresses

Primary practice location

146 N Pioneer Drive
Booker, TX 79005-6008

Mailing address

PO Box 550
Booker, TX 79005-0550
Phone (806) 658-4531

Other identifiers 1

IdentifierTypeStateIssuer
063663101MedicaidTX

Other names 1

  • Teare Memorial Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100427000149 TX Part A Provider - Rural Health Clinic 1658408471 Practice locations: Booker, TX
O20240813002033 TX Part B Supplier - Clinic/Group Practice 1658408471 Receives reassigned benefits from 1 practitioner
Practice locations: Booker, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699844878. Details of each certification follow.

Rural health clinic certification: CCN 458974

Legal name
BOOKER HOSPITAL DISTRICT
Doing business as
TEARE MEMORIAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 14, 1997
Last certification
Feb 19, 2020
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
146 N Pioneer Drive
Teare Memorial Clinic
Booker, TX 79005-6008

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
45D0934575Teare Memorial Clinic146 North Pioneer, Booker, TX 79005Certificate of waiverOct 7, 2027

National Provider Directory

National Provider Directory
Tax ID family
Teare Memorial Clinic12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Booker Hospital District Organization, Booker, TX Created for acquisition, Non-profit 5% Or Greater Direct Ownership Interest Nov 1, 1991 100%
Dwayne Armstrong Individual Corporate DirectorDirector Apr 1, 2003
W-2 Managing Employee Apr 1, 2003
Lisa Brown Individual Corporate OfficerAdministrator Jul 1, 2019 95%

Owners & managing parties with NPI records 9

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

All facility ownership & control disclosures 7

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

FacilityTypeRoleSince
Crosbyton Nursing and Rehabilitation CenterCrosbyton, TX, CCN 675291 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Apr 1, 2017
Apr 4, 2025
The Mildred & Shirley L. Garrison Geriatric Education & Care CtrLubbock, TX, CCN 675925 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2015
Magnolia Crossing Nursing and Rehabilitation CenterHouston, TX, CCN 676333 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Dec 1, 2021
Feb 26, 2025
San Rafael Nursing and Rehabilitation CenterCorpus Christi, TX, CCN 675717 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2021
Valley Grande ManorWeslaco, TX, CCN 455621 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2021
Oak Park Nursing and Rehabilitation CenterSan Antonio, TX, CCN 455789 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2022
Amarillo Medical LodgeAmarillo, TX, CCN 675282 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2023

Owned or controlled facilities with NPI records 7

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

Facilities with the same owner 7

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

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723593600000",
    "number": "1699844878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "BOOKER",
            "state": "TX",
            "postal_code": "790050550",
            "telephone_number": "806-658-4531",
            "fax_number": "806-658-9344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 N PIONEER DRIVE",
            "city": "BOOKER",
            "state": "TX",
            "postal_code": "790056008",
            "telephone_number": "806-658-4531",
            "fax_number": "806-658-9344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOOKER HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "APRN/ADMINISTRATOR",
        "authorized_official_telephone_number": "806-658-4531",
        "authorized_official_credential": "APRN, FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "TX",
            "license": "652675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063663101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Teare Memorial Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Teare Memorial Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Booker, TX

Sources for this page

Verify at the official NPI Registry.