NPIMap

Organization Active NPI

Bosque County Hospital District

Doing business as Goodall-Witcher Clinic in Clifton

  • Rural Health Clinic/Center
  • Clifton, TX
National Provider Identifier
1841752375
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BOSQUE COUNTY HOSPITAL DISTRICT
Doing business as
Goodall-Witcher Clinic in Clifton
Practice address
201 Posey Ave
Clifton, TX 76634-1200
Phone
(254) 675-8621
Fax
(254) 675-2254
NPI assigned
Apr 3, 2019
Last updated
Aug 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Authorized official

Name
Adam Willmann
Title
President/Ceo
Phone
(254) 675-8322

Specialties & licenses 1

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

Addresses

Primary practice location

201 Posey Ave
Clifton, TX 76634-1200

Mailing address

PO Box 72
Clifton, TX 76634-0072
Phone (254) 675-8621

Other names 1

  • Goodall-Witcher Clinic in Clifton Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190610001182 TX Part A Provider - Rural Health Clinic 4587997754 Practice locations: Clifton, TX
O20190819000832 TX Part B Supplier - Clinic/Group Practice 4587997754 Receives reassigned benefits from 41 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clifton, TX; Whitney, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1841752375. Details of each certification follow.

Rural health clinic certification: CCN 673995

Legal name
BOSQUE COUNTY HOSPITAL DISTRICT
Doing business as
GOODALL-WITCHER CLINIC IN CLIFTON
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 26, 1992
Last certification
Apr 2, 2025
Ownership / control type
Non-profit – church related
Most recent change of ownership
Jul 1, 2019 (2 total)
Organization structure
OtherNon-profit
Enrollment address
201 Posey Ave
Clifton, TX 76634-1200
Related CCNs
451385

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

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
45D0488341Goodall Witcher Clinic in Clifton201 Posey Avenue, Clifton, TX 76634Certificate of waiverJun 30, 2027

National Provider Directory

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
Vicki Gloff Individual Corporate DirectorController Dec 1, 2014
W-2 Managing EmployeeController Dec 1, 2014
Jerry L Pickett Individual W-2 Managing EmployeeCfo Jun 24, 2019
Charles Hopkins Individual Corporate OfficerBoard Director Jan 14, 2019
Roger Parks Individual Corporate OfficerSecretary/Treasurer Jan 14, 2019
Bosque County Hospital District Organization, Clifton, TX 5% Or Greater Direct Ownership Interest Jul 1, 2019 100%
Thomas Blossom Individual Corporate DirectorBoard Director May 22, 2020
Virginia Villarreal Individual Corporate OfficerBoard Director Jan 14, 2019
George Clifton Individual Corporate OfficerBoard Director Jan 14, 2019
Adam B Willmann Individual Corporate DirectorPresident/Ceo Dec 1, 2014
W-2 Managing EmployeePresident/Ceo Dec 1, 2014
Robert Phillips Individual Corporate DirectorBoard Director May 1, 2023
John Erickson Individual Corporate OfficerBoard Chairman Jan 14, 2019

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Goodall-Witcher HospitalClifton, TX, CCN 45Z385 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 2019
Jul 1, 2019
Goodall-Witcher HospitalClifton, TX, CCN 451385 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 2019
Jul 1, 2019
Sunset HomeClifton, TX, CCN 675826 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Jul 1, 2019
Jul 1, 2019
Jul 2, 2025
Goodall-Witcher Home Health AgencyClifton, TX, CCN 457688 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2019
Goodall-Witcher Clinic in WhitneyWhitney, TX, CCN 673436 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2019

Owned or controlled facilities with NPI records 5

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

Facilities with the same owner 5

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

Change-of-ownership history 1

DateEventCounterparty
Jul 1, 2019 Change of OwnershipThis provider was the buyer Clifton Medical ClinicCCN 673995, TX, NPI 1184666026

Change of ownership 1

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

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1841752375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 72",
            "city": "CLIFTON",
            "state": "TX",
            "postal_code": "766340072",
            "telephone_number": "254-675-8621",
            "fax_number": "254-675-2254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 POSEY AVE",
            "city": "CLIFTON",
            "state": "TX",
            "postal_code": "766341200",
            "telephone_number": "254-675-8621",
            "fax_number": "254-675-2254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSQUE COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-03",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A",
        "authorized_official_last_name": "WILLMANN",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "254-675-8322"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goodall-Witcher Clinic in Clifton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clifton, TX

Sources for this page

Verify at the official NPI Registry.