NPIMap

Organization Active NPI

Throckmorton County Memorial Hosp

  • Ambulance
  • Throckmorton, TX
National Provider Identifier
1932229697
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
224003 Issued in TX
Legal business name
THROCKMORTON COUNTY MEMORIAL HOSP
Practice address
802 N Minter Ave
Throckmorton, TX 76483-5357
Phone
(940) 849-2151
Fax
(940) 849-7141
NPI assigned
Mar 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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

Authorized official

Name
Mr. Kiby Gober, DVM
Title
Ceo
Phone
(940) 849-2151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 224003 TX Primary

Addresses

Primary practice location

802 N Minter Ave
Throckmorton, TX 76483-5357

Mailing address

PO Box 729
Throckmorton, TX 76483-0729
Phone (940) 849-2151

Other identifiers 1

IdentifierTypeStateIssuer
0881898-01MedicaidTX

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041124000382 TX Part A Provider - Hospital 4082686282 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Throckmorton, TX
O20200211000737 TX Part B Supplier - Ambulance Service Supplier 4082686282 Practice locations: Throckmorton, TX

Hospital certification: CCN 451339

Legal name
THROCKMORTON COUNTY MEMORIAL HOSP
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
May 1, 2003
Last certification
Oct 19, 2016
Beds
14
Ownership / control type
Local
Organization structure
OtherNon-profit
Enrollment address
802 N. Minter Ave
Throckmorton, TX 76483-5357
Other Hospital Practice Location
Hospital subgroups
Acute care, Swing-bed approved

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

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Throckmorton County Memorial HospitalCCN 451339
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Throckmorton Cty Mem Hosp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Karla Benson Individual W-2 Managing EmployeeBusiness Office Manager Nov 1, 2013
Kirby Gober Individual Corporate OfficerCeo Jun 20, 2014
Throckmorton County Memorial Hosp Organization, Throckmorton, TX Non-profit Operational/Managerial Control Nov 12, 2010

Owners & managing parties with NPI records 3

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
Throckmorton County Memorial HospThrockmorton, TX, CCN 451339 Hospital Operational/Managerial Control Nov 12, 2010
Throckmorton County Memorial HospThrockmorton, TX, CCN 45Z339 Hospital Operational/Managerial Control Nov 12, 2010
Throckmorton Rural Health ClinicThrockmorton, TX, CCN 458683 Rural health clinic Operational/Managerial Control Jun 29, 2010

Owned or controlled facilities with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 6

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": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648598400000",
    "number": "1932229697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 729",
            "city": "THROCKMORTON",
            "state": "TX",
            "postal_code": "764830729",
            "telephone_number": "940-849-2151",
            "fax_number": "940-849-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 N MINTER AVE",
            "city": "THROCKMORTON",
            "state": "TX",
            "postal_code": "764835357",
            "telephone_number": "940-849-2151",
            "fax_number": "940-849-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THROCKMORTON COUNTY MEMORIAL HOSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A",
        "authorized_official_last_name": "GOBER",
        "authorized_official_first_name": "KIBY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "940-849-2151",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DVM"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "TX",
            "license": "224003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0881898-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Throckmorton, TX

Sources for this page

Verify at the official NPI Registry.