Graham Hospital District
Organization Active NPI Rural Health Clinic/Center · Graham, TX
NPI 1922057561 · NPPES record last updated Aug 8, 2023
Key facts
- NPI
- 1922057561
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- GRAHAM HOSPITAL DISTRICT
- Practice address
- 820 Montgomery Rd
Suite 202
Graham, TX 76450-4200 - Phone
- (940) 549-7741
- Fax
- (940) 549-6265
- NPI assigned
- May 10, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- GRAHAM HOSPITAL DISTRICT
Authorized official
- Name
- Dora Castro
- Title
- Director of Business Office
- Phone
- (940) 521-5410
Related certifications (CCN) 1
Practitioners 4
-
Catherine Feist, FNP-C
-
Audra Kennedy, M.D.
-
Kippi Denise Lattimore, FNP-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D1025327 | Young County Family Clinic | Certificate of waiver | May 4, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
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
- Government · Non-profit
- Enrollment address
- 820 Montgomery Road
Suite 202
Graham, TX 76450-4200 - Related CCNs
- 671300
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Dianne a Smith |
Corporate Officer |
Mar 14, 2005 | 100% |
| W-2 Managing Employee |
Mar 14, 2005 | 100% | |
| Graham Hospital District |
5% Or Greater Direct Ownership Interest | Feb 1, 2014 | 100% |
| Kristi Rigsby |
Corporate Director |
Apr 28, 2025 | |
| Robert S. Kernell |
Corporate Officer |
Feb 29, 2016 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140529001487 | TX | Part a Provider - Rural Health Clinic | 1355564949 | Practice locations: Graham, TX |
National Provider Directory
- Part of
- Graham Hospital District
Locations
820 Montgomery Rd
Ste 202
Graham, TX 76450
Phone (940) 549-7741
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Rural Health Clinic/Center | 261QR1300X | Yes |
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
- dba: Young County Family Clinic
Other providers in Graham, TX
- Graham Hospital District
- Graham Hospital District
- Graham Hospital District
- Graham Hospital District
- Graham Hospital District
- Graham Hospital District
- Graham Hospital District Dba Graham Regional Home Health
- Graham Hospital District Dba Graham Regional Hospice
- Graham I Enterprises, LLC
- Graham Isd
All providers in Graham, TX · Rural Health Clinic/Center in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.