NPIMap

Organization Active NPI

Pecos County Memorial Hospital

  • Home Health Agency
  • Fort Stockton, TX
National Provider Identifier
1730113085
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
009326 Issued in TX
Legal business name
PECOS COUNTY MEMORIAL HOSPITAL
Doing business as
Pecos County Memorial Hospital Home Health
Practice address
387 W Ih 10
Fort Stockton, TX 79735
Phone
(432) 336-7044
Fax
(432) 336-2630
NPI assigned
Jul 11, 2006
Organization subpart
Yes
Parent organization
PECOS COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

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

Authorized official

Name
Mrs. Betsy Briscoe, CEO
Title
Director of Provider Enrollment
Phone
(432) 336-4200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 009326 TX Primary

Addresses

Primary practice location

387 W Ih 10
Fort Stockton, TX 79735

Mailing address

387 W Ih 10
Fort Stockton, TX 79735-2700
Phone (432) 336-7044

Other identifiers 2

IdentifierTypeStateIssuer
130616907MedicaidTX
HH473HOtherTXBCBS PROVIDER NUMBER

Other names 1

  • Pecos County Memorial Hospital Home Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Part of
Pecos County Memorial

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Jul 1, 2023 Change of OwnershipThis provider was the seller Pecos County Memorial Hospital Home Health & HospiceCCN 673107, TX, NPI 1235913575

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573171200000",
    "number": "1730113085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "387 W IH 10",
            "city": "FORT STOCKTON",
            "state": "TX",
            "postal_code": "797352700",
            "telephone_number": "432-336-7044",
            "fax_number": "432-336-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "387 W IH 10",
            "city": "FORT STOCKTON",
            "state": "TX",
            "postal_code": "79735",
            "telephone_number": "432-336-7044",
            "fax_number": "432-336-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECOS COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PECOS COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2006-07-11",
        "last_updated": "2019-11-08",
        "status": "A",
        "authorized_official_last_name": "BRISCOE",
        "authorized_official_first_name": "BETSY",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER  ENROLLMENT",
        "authorized_official_telephone_number": "432-336-4200",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "009326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130616907",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "HH473H",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pecos County Memorial Hospital Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Stockton, TX

Sources for this page

Verify at the official NPI Registry.