NPIMap

Organization Active NPI

Anson Hospital District

Doing business as Anson Family Wellness Clinic

  • Rural Health Clinic/Center
  • Anson, TX
National Provider Identifier
1891737920
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
000016 Issued in TX
Legal business name
ANSON HOSPITAL DISTRICT
Doing business as
Anson Family Wellness Clinic
Practice address
215 N Avenue J
Anson, TX 79501-2114
Phone
(325) 823-3209
Fax
(325) 823-3600
NPI assigned
Jun 12, 2006
Last updated
Jun 25, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
ANSON HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Authorized official

Name
Ms. Justa Clark
Title
Ceo
Phone
(325) 823-1154

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 000016 TX Primary

Addresses

Primary practice location

215 N Avenue J
Anson, TX 79501-2114

Mailing address

101 Avenue J
Anson, TX 79501-2113
Phone (325) 823-3231

Other identifiers 5

IdentifierTypeStateIssuer
124821OtherTXSUPERIOR
127731100OtherTXFIRSTCARE
00J28TOtherTXBCBS
063693801MedicaidTX
362063501MedicaidTX

Other names 1

  • Anson Family Wellness Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160622000435 TX Part A Provider - Rural Health Clinic 4880983428 Practice locations: Anson, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891737920. Details of each certification follow.

Rural health clinic certification: CCN 673989

Legal name
ANSON HOSPITAL DISTRICT
Doing business as
ANSON FAMILY WELLNESS CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 16, 1992
Last certification
Mar 24, 2025
Ownership / control type
2A
Most recent change of ownership
Apr 1, 2016 (1 total)
Organization structure
GovernmentNon-profit
Enrollment address
101 Avenue J
Anson, TX 79501-2113
Related CCNs
670781

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

Other NPIs with the same Medicare PAC ID 4

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

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
45D0508106Anson Family Wellness Clinic101 Avenue J Anson, Anson, TX 79501Certificate of waiverDec 31, 2027

National Provider Directory

National Provider Directory
Tax ID family
Anson Hospital District5 organizations share this tax ID, including this one
Part of
Anson Hospital District

Other organizations with this tax ID 4

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

Member organizations 5

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Anson Hospital District Organization, Anson, TX Created for acquisition 5% Or Greater Direct Ownership Interest Apr 1, 2016 100%
Justa Clark Individual Corporate DirectorChief Executive Officer Jan 6, 2025
Julie Pritchard Individual Corporate DirectorClinic Manager Jul 15, 2024
W-2 Managing EmployeeClinic Manager Jul 15, 2024
Mark Nunez Individual Corporate DirectorAdminissions Oct 5, 1996

Owners & managing parties with NPI records 4

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
Anson General HospitalAnson, TX, CCN 670781 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2016
Los Arcos del Norte Care CenterEl Paso, TX, CCN 676283 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2019
Legacy Nursing and RehabilitationBryan, TX, CCN 455351 Skilled nursing facility 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Sep 1, 2025
Sep 1, 2025

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.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782345600000",
    "number": "1891737920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 AVENUE J",
            "city": "ANSON",
            "state": "TX",
            "postal_code": "795012113",
            "telephone_number": "325-823-3231",
            "fax_number": "325-823-3098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N AVENUE J",
            "city": "ANSON",
            "state": "TX",
            "postal_code": "795012114",
            "telephone_number": "325-823-3209",
            "fax_number": "325-823-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANSON HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANSON HOSPITAL DISTRICT",
        "enumeration_date": "2006-06-12",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JUSTA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "325-823-1154",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "TX",
            "license": "000016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPERIOR",
            "identifier": "124821",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE",
            "identifier": "127731100",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00J28T",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063693801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362063501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anson Family Wellness Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anson, TX

Sources for this page

Verify at the official NPI Registry.