Progressive Health of Fayette Inc.

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

PROGRESSIVE HEALTH OF FAYETTE INC.

Doing business as

Fayette Family and Specialty Clinic

Practice address

750 W Travis St
La Grange, TX 78945-2522

Phone

(999) 999-9999

NPI assigned

Nov 26, 2025

Organization subpart

Yes

Parent organization

PROGRESSIVE HEALTH OF FAYETTE INC.As reported in NPPES

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

Authorized official

Name

Robert Quentin Whitwell Jr.

Title

Ceo

Phone

(662) 701-8766

Specialties & licenses 1

Addresses

Other names 1

• Fayette Family and Specialty Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Rural health clinic certification: CCN 678903

Legal name

PROGRESSIVE HEALTH OF FAYETTE INC.

Doing business as

FAYETTE FAMILY AND SPECIALTY CLINIC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Sep 1, 2022

Last certification

Aug 25, 2025

Ownership / control type

Non-profit – church related

Most recent change of ownership

Jan 1, 2026 (1 total)

Organization structure

CorporationProprietary

Enrollment address

750 W Travis St
La Grange, TX 78945-2522

Tax ID family

Progressive Health of Fayette Inc2 organizations share this tax ID, including this one

Part of

Progressive Health of Fayette Inc

Other organizations with this tax ID 1

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

• Progressive Health of Fayette Inc.

  • Rural Acute Care Hospital
  • La Grange, TX
  • NPI 1306708532
  NPD tax ID

Locations

All disclosed owners & managing parties 2

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

Change-of-ownership history 1

Change of ownership 1

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

• Bluebonnet Trails Community MHMR Center

  • Rural Health Clinic/Center
  • La Grange, TX
  • NPI 1518536309

  Acquired from, 2026-01-01

  CMS change of ownership

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Progressive Health of Fayette Inc.

  • Rural Acute Care Hospital
  • La Grange, TX
  • NPI 1306708532
  NPPES parent name

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

{
    "created_epoch": "1764115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779840000000",
    "number": "1740142942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SAINT MARKS PL",
            "city": "LA GRANGE",
            "state": "TX",
            "postal_code": "789451250",
            "telephone_number": "999-999-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 W TRAVIS ST",
            "city": "LA GRANGE",
            "state": "TX",
            "postal_code": "789452522",
            "telephone_number": "999-999-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE HEALTH OF FAYETTE INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROGRESSIVE HEALTH OF FAYETTE INC.",
        "enumeration_date": "2025-11-26",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A",
        "authorized_official_last_name": "WHITWELL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "QUENTIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-701-8766",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fayette Family and Specialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alaina Christen Petzold, PT, DPT
• Hanna Florence Pilat, PA-C
• Anant Chelva Praba, M.D.
• Rose Lee Prashad, PHD
• Progressive Health of Fayette Inc.
• Hans James Raj, MD
• Charlotte Blauert Reilly, CRNA, DNP
• Reagan Renee Richter, FNP-C
• Robert H Smalley Mdpa
• Karen A Roberts, DDS

• Rural Health Clinic/Center in La Grange, TX
• Providers in La Grange, TX by specialty
• Rural Health Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.