NPIMap

Organization Active NPI

South Limestone Hospital District

Doing business as Kosse Community Health Clinic A Limestone Medical Center Clinic

  • Rural Health Clinic/Center
  • Kosse, TX
National Provider Identifier
1710539465
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SOUTH LIMESTONE HOSPITAL DISTRICT
Doing business as
Kosse Community Health Clinic A Limestone Medical Center Clinic
Practice address
206 Narcissus St
Kosse, TX 76653
Phone
(254) 729-3281
Fax
(254) 729-3080
NPI assigned
Jul 12, 2019
Last updated
Jul 21, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTH LIMESTONE HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Authorized official

Name
Mr. Larry N Price
Title
Ceo/Administrator
Phone
(254) 729-3281

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

206 Narcissus St
Kosse, TX 76653

Mailing address

701 McClintic Dr
Groesbeck, TX 76642-2128
Phone (254) 729-3281

Other names 1

  • Kosse Community Health Clinic A Limestone Medical Center Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200103000087 TX Part A Provider - Rural Health Clinic 9032103700 Practice locations: Kosse, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1710539465. Details of each certification follow.

Rural health clinic certification: CCN 673482

Legal name
SOUTH LIMESTONE HOSPITAL DISTRICT
Doing business as
KOSSE COMMUNITY HEALTH CLINIC A LIMESTONE MEDICAL CENTER CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 9, 2020
Last certification
Mar 24, 2026
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
206 North Narcissus Street
Kosse, TX 76653-3538
Related CCNs
451303

Facilities connected through Provider of Services related, parent or unit certification numbers.

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
45D2171652Kosse Community Health Clinic206 N Narcissus St, Kosse, TX 76653Certificate of waiverSep 4, 2027

National Provider Directory

National Provider Directory
Tax ID family
Robert C Matlock MD34 organizations share this tax ID, including this one
Part of
Robert C Matlock MD

Other organizations with this tax ID 33

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

View all 33

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Larry N Price Individual Corporate OfficerCeo Administrator Jun 1, 1982
W-2 Managing EmployeeCeo Administrator Jun 1, 1982
Arnold Gray Individual Corporate DirectorDirector May 16, 2018
Herbert D Hewitt Individual Corporate OfficerPresident Board of Directors May 26, 2009
Jack Milstead Individual Corporate DirectorDirector Jan 22, 2019
Kent Wilson Individual Corporate Director Jan 25, 2022
Jeffrey D Rettig Individual W-2 Managing EmployeeOD Jul 23, 2018
Jennifer E. Mackey Individual Corporate DirectorDirector May 26, 2020
Debbie Brewer Individual W-2 Managing Employee Nov 18, 2019
Tamara Taylor Individual W-2 Managing EmployeeClinic Manager Nov 18, 2019
South Limestone Hospital District Organization, Groesbeck, TX 5% Or Greater Direct Ownership Interest Apr 1, 2015 100%
Martha L Stanton Individual Corporate OfficerVP Board of Directors Jul 24, 2012
Glenda R O'Neal Individual Corporate DirectorSecretary/Treas Board of Direct Jul 24, 2012

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 30

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

FacilityTypeRoleSince
Limestone Medical CenterGroesbeck, TX, CCN 451303 Hospital Operational/Managerial Control (14%) Aug 5, 1996
Limestone Medical CenterGroesbeck, TX, CCN 45Z303 Hospital Operational/Managerial Control Aug 5, 1996
Accel at Willow BendPlano, TX, CCN 676349 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 27, 2015
Garnet Hill Rehabilitation and Skilled CareWylie, TX, CCN 676192 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 27, 2015
Settlers Ridge Care CenterCelina, TX, CCN 675969 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 27, 2015
The Villages on MacarthurIrving, TX, CCN 676358 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 27, 2015
Baybrooke Village Care and Rehab CenterMcKinney, TX, CCN 676096 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 27, 2015
Woodland Springs Nursing CenterWaco, TX, CCN 675360 Skilled nursing facility Operational/Managerial Control (50%) Jan 23, 2015
Georgetown Nursing and Transitional CareGeorgetown, TX, CCN 676280 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Apr 1, 2017
Sep 30, 2025
Creekside Terrace RehabilitationBelton, TX, CCN 455497 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
San Gabriel Rehabilitation and Care CenterRound Rock, TX, CCN 676308 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Groesbeck LTC Nursing and RehabilitationGroesbeck, TX, CCN 676071 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018
Teague Nursing and RehabilitationTeague, TX, CCN 675884 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018
Mexia LTC Nursing and RehabilitationMexia, TX, CCN 675903 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Apr 1, 2018
Apr 23, 2025
Falcon Ridge RehabilitationHutto, TX, CCN 676382 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2019
Briarcliff Health CenterTyler, TX, CCN 675142 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2019
Chandler Health CareChandler, TX, CCN 455910 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2019
Providence Park Rehabilitation and Skilled NursingTyler, TX, CCN 676184 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2020
Avir at BeltonBelton, TX, CCN 675948 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2021
Van HealthcareVan, TX, CCN 455856 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2022
Panola County Nursing & RehabilitationCarthage, TX, CCN 675387 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 15, 2024
Crimson Heights Health & WellnessHumble, TX, CCN 676463 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2024
Terra Bella Health and Wellness SuitesHouston, TX, CCN 676450 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2024
St. Joseph's Care CenterMcGregor, TX, CCN 745059 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2024
The Chateau WacoWaco, TX, CCN 676409 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2025
Avir at CorsicanaCorsicana, TX, CCN 676295 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2025
St. Anthony's Care CenterWaco, TX, CCN 676462 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2025
West Rest HavenWest, TX, CCN 676386 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2025
Rettig Family Health Care a Limestone Medical Center ClinicGroesbeck, TX, CCN 673480 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2015
Family Medicine CenterGroesbeck, TX, CCN 453984 Rural health clinic Operational/Managerial Control Mar 28, 2022

Facilities with the same owner 29

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

View all 29

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": "1562889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595289600000",
    "number": "1710539465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 MCCLINTIC DR",
            "city": "GROESBECK",
            "state": "TX",
            "postal_code": "766422128",
            "telephone_number": "254-729-3281",
            "fax_number": "254-729-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 NARCISSUS ST",
            "city": "KOSSE",
            "state": "TX",
            "postal_code": "76653",
            "telephone_number": "254-729-3281",
            "fax_number": "254-729-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH LIMESTONE HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH LIMESTONE HOSPITAL DISTRICT",
        "enumeration_date": "2019-07-12",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "254-729-3281",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kosse Community Health Clinic A Limestone Medical Center Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kosse Community Health Clinic A Limestone Medical Center Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kosse, TX

Sources for this page

Verify at the official NPI Registry.