NPIMap

Organization Active NPI

Ballinger Memorial Hospital District

  • Medicare Defined Swing Bed Hospital Unit
  • Ballinger, TX
National Provider Identifier
1922062017
Registry record updated Jan 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
000234 Issued in TX
Legal business name
BALLINGER MEMORIAL HOSPITAL DISTRICT
Practice address
608 Avenue B
Ballinger, TX 76821-2406
Phone
(325) 365-2531
Fax
(325) 365-5689
NPI assigned
Apr 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2016

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

Authorized official

Name
Rhett D. Fricke
Title
Ceo/Administrator
Phone
(325) 365-2531

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 000234 TX Primary

Addresses

Primary practice location

608 Avenue B
Ballinger, TX 76821-2406

Mailing address

PO Box 617
Ballinger, TX 76821-0617
Phone (325) 365-2531

Other names 1

  • Ballinger Memorial Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081009000774 TX Part A Provider - Critical Access Hospital 0042200180 Receives reassigned benefits from 2 practitioners
Practice locations: Ballinger, TX

Hospital certification: CCN 45Z310

Legal name
BALLINGER MEMORIAL HOSPITAL DISTRICT
Doing business as
BALLINGER MEMORIAL HOSPITAL
Organization structure
OtherNon-profit
Enrollment address
608 Avenue B
Ballinger Memorial Hospital
Ballinger, TX 76821-2406
Other Hospital Practice Location

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
Ballinger Memorial Hospital District7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

608 Avenue B
Ballinger, TX 76821
Phone (325) 365-2531

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
Ballinger Memorial Hospital District Organization, Ballinger, TX 5% Or Greater Direct Ownership Interest Jan 1, 1990
Antoinette Sehon Individual Corporate OfficerCfo Sep 26, 2019
W-2 Managing EmployeeCfo Nov 28, 2016
Operational/Managerial ControlCfo Nov 28, 2016
Rebecca Ellis Individual Corporate OfficerDirector of Nurses Sep 26, 2019
W-2 Managing EmployeeDirector of Nurses Apr 24, 2015
Operational/Managerial ControlDirector of Nurses Apr 24, 2015
Rhett Fricke Individual Corporate OfficerCeo/Administrator Sep 26, 2019
W-2 Managing EmployeeCeo/Administrator Nov 16, 2015 100%
Operational/Managerial ControlCeo/Administrator Nov 16, 2015 100%

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 5

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

FacilityTypeRoleSince
Ballinger Memorial HospitalBallinger, TX, CCN 451310 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 24, 2008
Ballinger Healthcare and Rehabilitation CenterBallinger, TX, CCN 675614 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2022
Park Plaza Nursing and Rehabilitation CenterSan Angelo, TX, CCN 675982 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2024
Cedar Manor Nursing and Rehabilitation CenterSan Angelo, TX, CCN 676068 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2024
Ballinger Hospital ClinicBallinger, TX, CCN 458867 Rural health clinic 5% Or Greater Direct Ownership Interest Nov 1, 2005

Owned or controlled facilities with NPI records 6

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.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453334400000",
    "number": "1922062017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 617",
            "city": "BALLINGER",
            "state": "TX",
            "postal_code": "768210617",
            "telephone_number": "325-365-2531",
            "fax_number": "325-365-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 AVENUE B",
            "city": "BALLINGER",
            "state": "TX",
            "postal_code": "768212406",
            "telephone_number": "325-365-2531",
            "fax_number": "325-365-5689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALLINGER MEMORIAL HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-14",
        "last_updated": "2016-01-21",
        "status": "A",
        "authorized_official_last_name": "FRICKE",
        "authorized_official_first_name": "RHETT",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "325-365-2531"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "TX",
            "license": "000234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ballinger Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ballinger, TX

Sources for this page

Verify at the official NPI Registry.