NPIMap

Organization Active NPI

Gonzales Healthcare Systems

Doing business as Sievers Medical Clinic - Shiner

  • Rural Health Clinic/Center
  • Shiner, TX
National Provider Identifier
1821551581
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GONZALES HEALTHCARE SYSTEMS
Doing business as
Sievers Medical Clinic - Shiner
Practice address
207 West 7TH Street
Shiner, TX 77984
Phone
(361) 239-5015
Fax
(830) 672-8481
NPI assigned
Apr 10, 2019
Last updated
Feb 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Authorized official

Name
Mr. Brandon Anzaldua
Title
Compliance Officer
Phone
(830) 672-7581

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

207 West 7TH Street
Shiner, TX 77984

Mailing address

1110 N Sarah Dewitt Dr
Gonzales, TX 78629-3311
Phone (830) 672-7581

Other names 1

  • Sievers Medical Clinic - Shiner Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200214002062 TX Part A Provider - Rural Health Clinic 8527963776 Practice locations: Shiner, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821551581. Details of each certification follow.

Rural health clinic certification: CCN 673488

Legal name
GONZALES HEALTHCARE SYSTEMS
Doing business as
SIEVERS MEDICAL CLINIC - SHINER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 18, 2020
Last certification
Jun 7, 2023
Ownership / control type
2A
Organization structure
OtherNon-profit
Incorporated
May 13, 1975 in TX
Enrollment address
207 W 7TH St
Shiner, TX 77984-5873
Related CCNs
450235

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

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
Gonzales Healthcare Systems13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Brandon Anzaldua Individual Corporate OfficerCeo Aug 1, 2023
Wayne South Individual Corporate Director Jun 4, 2019
Gregory Charles Tieken Individual Corporate Director May 5, 2016
William V Bailey Individual Corporate OfficerCfo Jul 5, 2023
Kenneth Gottwald Individual Corporate Director May 12, 2012
Gene Reed Individual Corporate Officer May 8, 2010
Stephanie L Kodack Individual Corporate Director Jun 29, 2017
Juli Clay Individual Corporate OfficerCompliance Officer Dec 1, 2001
W-2 Managing EmployeeCompliance Officer Dec 1, 2001
Gonzales Healthcare Systems Organization, Gonzales, TX 5% Or Greater Direct Ownership Interest Mar 1, 2020 100%
Lisa Gindler Individual Corporate DirectorBoard of Directors May 8, 1995
Sascha Kardosz Individual Corporate Director May 5, 2018

Owners & managing parties with NPI records 7

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
Memorial HospitalGonzales, TX, CCN 450235 Hospital Operational/Managerial Control Jul 15, 2010
The Heights of GonzalesGonzales, TX, CCN 676138 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 31, 2013
Avir at GonzalesGonzales, TX, CCN 675124 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2025
Avir at MagnoliaLuling, TX, CCN 676044 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2015
Memorial Hospital Home Health AgencyGonzales, TX, CCN 457634 Home health agency Other (100%) Jun 1, 1984
Sievers Medical ClinicGonzales, TX, CCN 453456 Rural health clinic Operational/Managerial Control Jul 15, 2010
Sievers Medical Clinic - WaelderWaelder, TX, CCN 453481 Rural health clinic Operational/Managerial Control (100%) Jul 15, 2010

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 6

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1554854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1821551581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 N SARAH DEWITT DR",
            "city": "GONZALES",
            "state": "TX",
            "postal_code": "786293311",
            "telephone_number": "830-672-7581",
            "fax_number": "830-672-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 WEST 7TH STREET",
            "city": "SHINER",
            "state": "TX",
            "postal_code": "77984",
            "telephone_number": "361-239-5015",
            "fax_number": "830-672-8481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GONZALES HEALTHCARE SYSTEMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-10",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A",
        "authorized_official_last_name": "ANZALDUA",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "830-672-7581",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sievers Medical Clinic - Shiner",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sievers Medical Clinic - Shiner",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shiner, TX

Sources for this page

Verify at the official NPI Registry.