NPIMap

Organization Active NPI

Graham Hospital District

Doing business as dba: Young County Family Clinic

  • Rural Health Clinic/Center
  • Graham, TX
National Provider Identifier
1922057561
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GRAHAM HOSPITAL DISTRICT
Doing business as
dba: Young County Family Clinic
Practice address
820 Montgomery Rd
Suite 202
Graham, TX 76450-4200
Phone
(940) 549-7741
Fax
(940) 549-6265
NPI assigned
May 10, 2006
Last updated
Aug 8, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
GRAHAM HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Authorized official

Name
Dora Castro
Title
Director of Business Office
Phone
(940) 521-5410

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

820 Montgomery Rd
Suite 202
Graham, TX 76450-4200

Mailing address

820 Montgomery Rd
Suite 202
Graham, TX 76450-4200
Phone (940) 549-7741

Other names 1

  • dba: Young County Family Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140529001487 TX Part A Provider - Rural Health Clinic 1355564949 Practice locations: Graham, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922057561. Details of each certification follow.

Rural health clinic certification: CCN 458851

Legal name
GRAHAM HOSPITAL DISTRICT
Doing business as
YOUNG COUNTY FAMILY CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 20, 2004
Last certification
Mar 19, 2026
Ownership / control type
Non-profit – church related
Most recent change of ownership
Feb 1, 2014 (1 total)
Organization structure
GovernmentNon-profit
Enrollment address
820 Montgomery Road
Suite 202
Graham, TX 76450-4200
Related CCNs
671300

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

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
45D1025327Young County Family Clinic820 Montgomery Rd, Suite 202, Graham, TX 76450Certificate of waiverMay 4, 2028

National Provider Directory

National Provider Directory
Part of
Graham Hospital District

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
Dianne a Smith Individual Corporate OfficerOffice Manager Mar 14, 2005 100%
W-2 Managing EmployeeOffice Manager Mar 14, 2005 100%
Graham Hospital District Organization, Graham, TX Created for acquisition 5% Or Greater Direct Ownership Interest Feb 1, 2014 100%
Kristi Rigsby Individual Corporate DirectorClinic Administrator Apr 28, 2025
Robert S. Kernell Individual Corporate OfficerCeo Feb 29, 2016 100%

Practitioners & affiliated clinicians

Practitioners 4

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": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691452800000",
    "number": "1922057561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 MONTGOMERY RD",
            "address_2": "SUITE 202",
            "city": "GRAHAM",
            "state": "TX",
            "postal_code": "764504200",
            "telephone_number": "940-549-7741",
            "fax_number": "940-549-6265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 MONTGOMERY RD",
            "address_2": "SUITE 202",
            "city": "GRAHAM",
            "state": "TX",
            "postal_code": "764504200",
            "telephone_number": "940-549-7741",
            "fax_number": "940-549-6265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAHAM HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRAHAM HOSPITAL DISTRICT",
        "enumeration_date": "2006-05-10",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A",
        "authorized_official_last_name": "CASTRO",
        "authorized_official_first_name": "DORA",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS OFFICE",
        "authorized_official_telephone_number": "940-521-5410"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba: Young County Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Graham, TX

Sources for this page

Verify at the official NPI Registry.