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Organization Active NPI

Mitchell County Hospital District

  • Critical Access Hospital
  • Colorado City, TX
National Provider Identifier
1801087630
Registry record updated Feb 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
75 Issued in TX
Legal business name
MITCHELL COUNTY HOSPITAL DISTRICT
Practice address
997 West I-20
Colorado City, TX 79512
Phone
(325) 728-3431
Fax
(325) 728-8974
NPI assigned
Aug 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2011

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

Authorized official

Name
Ms. Karen Holman
Title
Administrative Secretary
Phone
(325) 728-3431

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 75 TX
Critical Access Hospital 282NC0060X 75 TX Primary

Addresses

Primary practice location

997 West I-20
Colorado City, TX 79512

Mailing address

997 West I-20
Colorado City, TX 79512
Phone (325) 728-3431

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101029000306 TX Part A Provider - Critical Access Hospital 9739071176 Practice locations: Colorado City, TX

Hospital certification: CCN 45Z342

Legal name
MITCHELL COUNTY HOSPITAL DISTRICT
Organization structure
GovernmentNon-profit
Incorporated
Jan 1, 1967 in TX
Enrollment address
997 W Interstate 20
Colorado City, TX 79512-2685
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory

Member of 1

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

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
Patricia G Pharis Individual Corporate DirectorBoard Member May 22, 2007
Henryk Olstowski Individual Corporate DirectorBoard Member Mar 22, 2022
Suzanne Michelle Gafford Individual Corporate DirectorChief Executive Officer Dec 1, 2022
W-2 Managing EmployeeChief Executive Officer Dec 1, 2022
Cheryl Warren Individual Corporate DirectorBoard Member Apr 30, 2013
Helen Edwards Individual Corporate DirectorBoard Member Nov 1, 2019
Robert Hall Individual Corporate DirectorChief Operating Officer Sep 1, 2022
W-2 Managing EmployeeChief Operating Officer Sep 1, 2022
Rural Hospital Management Organization, Lubbock, TX Management services company Operational/Managerial Control Sep 16, 2008
Randall Anderson Individual Corporate DirectorBoard Member Apr 27, 2021
Marsha Rickard Individual Corporate DirectorBoard Member May 18, 2016
Maria Rubio Individual Corporate DirectorBoard Member Jul 24, 2018
Diane C Moore Individual Corporate DirectorChief Financial Officer Apr 24, 2023
W-2 Managing EmployeeChief Financial Officer Apr 24, 2023
Mitchell County Hospital District Organization, Colorado City, TX Operational/Managerial Control Sep 1, 2010

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Mitchell County Hospital DistrictColorado City, TX, CCN 451342 Hospital Operational/Managerial Control Sep 1, 2010
Mitchell County Nursing and Rehabilitation CenterColorado City, TX, CCN 676225 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Jan 1, 1967
Dec 30, 2024
Jan 14, 2025
Family Medical AssociatesColorado City, TX, CCN 453403 Rural health clinic Operational/Managerial Control (100%) Jan 1, 1992

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298505600000",
    "number": "1801087630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "997 WEST I-20",
            "city": "COLORADO CITY",
            "state": "TX",
            "postal_code": "79512",
            "telephone_number": "325-728-3431",
            "fax_number": "325-728-8974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "997 WEST I-20",
            "city": "COLORADO CITY",
            "state": "TX",
            "postal_code": "79512",
            "telephone_number": "325-728-3431",
            "fax_number": "325-728-8974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITCHELL COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2011-02-24",
        "status": "A",
        "authorized_official_last_name": "HOLMAN",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "ADMINISTRATIVE SECRETARY",
        "authorized_official_telephone_number": "325-728-3431",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "TX",
            "license": "75",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "TX",
            "license": "75",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado City, TX

Sources for this page

Verify at the official NPI Registry.