Active NPI
Quitman Hospital LLC
- Rural Health Clinic/Center
- Canton, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rural Health Clinic/Center
- Legal business name
- QUITMAN HOSPITAL LLC
- Practice address
- 406 E State Highway 243
Canton, TX 75103-2409 - Phone
- (903) 962-7551
- Fax
- (903) 962-7122
- NPI assigned
- Feb 10, 2018
- Last updated
- Oct 1, 2023
- Organization subpart
- Yes
- Parent organization
- AHS EAST TEXAS HEALTH SYSTEM, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stephen C. Petrovich
- Title
- Evp
- Phone
- (615) 296-3000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | NU | Primary |
Addresses
Primary practice location
406 E State Highway 243
Canton, TX 75103-2409
Mailing address
340 Seven Springs Way Ste 100
Brentwood, TN 37027-5697
Phone (615) 296-3000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180525000819 | TX | Part A Provider - Rural Health Clinic | 9133484330 | Practice locations: Canton, TX |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1932608452. Details of each certification follow.
Rural health clinic certification: CCN 673444
- Legal name
- QUITMAN HOSPITAL LLC
- Doing business as
- UT HEALTH EAST TEXAS QUITMAN HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Sep 12, 2016
- Last certification
- Mar 1, 2022
- Ownership / control type
- 1B
- Most recent change of ownership
- Mar 1, 2018 (1 total)
- Organization structure
- LLC
- Incorporated
- Dec 19, 2017 in DE
- Enrollment address
- 406 E State Highway 243
Canton, TX 75103-2409 - Related CCNs
- 451380
Related certifications (CCN) 1
Facilities connected through Provider of Services related, parent or unit certification numbers.
Other NPIs with the same Medicare PAC ID 5
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Quitman Hospital LLC
Other organizations with this tax ID 6
Organizations that report the same tax identification number in the National Provider Directory.
-
- Rural Health Clinic/Center
- Mineola, TX
- NPI 1205335726
-
- Internal Medicine Physician
- Quitman, TX
- NPI 1205336609
-
- Rural Health Clinic/Center
- Quitman, TX
- NPI 1306345764
-
- Critical Access Hospital
- Quitman, TX
- NPI 1477061885
-
- Certified Registered Nurse Anesthetist
- Quitman, TX
- NPI 1629571773
-
- Rural Health Clinic/Center
- Winnsboro, TX
- NPI 1861109654
Ownership & related parties
All disclosed owners & managing parties 9
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Ardent Health Inc | 5% Or Greater Indirect Ownership Interest | Mar 1, 2018 | 100% |
| Ahs Texas, LLC | 5% Or Greater Indirect Ownership Interest | Jan 1, 2021 | 100% |
| Mary a Crabtree | Corporate Officer | Mar 1, 2018 | |
| Ahs Management Company Inc. | Operational/Managerial Control | Mar 1, 2018 | |
| Stephen C Petrovich | Corporate Officer | Mar 1, 2018 | |
| Ardent Legacy Holdings LLC | 5% Or Greater Indirect Ownership Interest | Mar 1, 2018 | 100% |
| Ahs East Texas Health System, LLC | 5% Or Greater Direct Ownership Interest | Mar 1, 2018 | 100% |
| Donald Baker | Corporate Director | Jun 1, 2021 | 100% |
| W-2 Managing Employee | Jun 1, 2021 | ||
| Ahp Health Partners, Inc | 5% Or Greater Indirect Ownership Interest | Mar 1, 2018 | 100% |
Facilities with the same owner 61
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- General Acute Care Hospital
- Athens, TX
- NPI 1417465824
Ahp Health Partners, Inc, Ahs East Texas Health System, LLC, Ahs Management Company Inc., Ahs Texas, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC
-
- General Acute Care Hospital
- Amarillo, TX
- NPI 1407191984
Ahp Health Partners, Inc, Ahs Management Company Inc., Ardent Health Inc, Ardent Legacy Holdings LLC
-
- Rehabilitation Hospital Unit
- Amarillo, TX
- NPI 1730425190
Ahp Health Partners, Inc, Ahs Management Company Inc., Ardent Health Inc, Ardent Legacy Holdings LLC
-
- Rural Health Clinic/Center
- Carthage, TX
- NPI 1407355860
Ahp Health Partners, Inc, Ahs East Texas Health System, LLC, Ahs Management Company Inc., Ahs Texas, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC
-
- General Acute Care Hospital
- Carthage, TX
- NPI 1538667035
Ahp Health Partners, Inc, Ahs East Texas Health System, LLC, Ahs Management Company Inc., Ahs Texas, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC
-
- Rural Health Clinic/Center
- Carthage, TX
- NPI 1639678030
Ahp Health Partners, Inc, Ahs East Texas Health System, LLC, Ahs Management Company Inc., Ahs Texas, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC
-
dba Rehabilitation Hospital of Amarillo
- Rehabilitation Hospital
- Amarillo, TX
- NPI 1487443099
Ahp Health Partners, Inc, Ardent Health Inc, Ardent Legacy Holdings LLC
-
- Rural Health Clinic/Center
- Chandler, TX
- NPI 1235706581
Ahp Health Partners, Inc, Ahs East Texas Health System, LLC, Ahs Management Company Inc., Ahs Texas, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC
-
- Rural Health Clinic/Center
- Gun Barrel City, TX
- NPI 1689241945
Ahp Health Partners, Inc, Ahs East Texas Health System, LLC, Ahs Management Company Inc., Ahs Texas, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC
-
dba BSA Hospice of the Southwest
- Community Based Hospice Care Agency
- Amarillo, TX
- NPI 1467447854
Ardent Legacy Holdings LLC
-
dba UTHealth East Texas Henderson Hospital
- General Acute Care Hospital
- Henderson, TX
- NPI 1326546797
Ahp Health Partners, Inc, Ahs East Texas Health System, LLC, Ahs Management Company Inc., Ahs Texas, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC
-
- Rural Health Clinic/Center
- Henderson, TX
- NPI 1952800310
Ahp Health Partners, Inc, Ahs East Texas Health System, LLC, Ahs Management Company Inc., Ahs Texas, LLC, Ardent Health Inc, Ardent Legacy Holdings LLC
Practitioners & affiliated clinicians
Practitioners 30
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.
-
- Nurse Practitioner
- Tyler, TX
- NPI 1003414525
-
- Surgery Physician
- Quitman, TX
- NPI 1194815886
-
- Interventional Cardiology Physician
- Tyler, TX
- NPI 1871588012
-
- Family Nurse Practitioner
- Longview, TX
- NPI 1215271481
-
- Gerontology Nurse Practitioner
- Quitman, TX
- NPI 1457726085
-
- Family Medicine Physician
- Texarkana, TX
- NPI 1720516719
-
- Family Medicine Physician
- Quitman, TX
- NPI 1376077164
-
- Family Medicine Physician
- Quitman, TX
- NPI 1972248367
-
- Nurse Practitioner
- Tyler, TX
- NPI 1619371960
-
- Family Nurse Practitioner
- Mineola, TX
- NPI 1942064670
-
- Family Nurse Practitioner
- Quitman, TX
- NPI 1902349111
-
- Acute Care Nurse Practitioner
- Tyler, TX
- NPI 1306496435
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518220800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1696118400000",
"number": "1932608452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 SEVEN SPRINGS WAY STE 100",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370275697",
"telephone_number": "615-296-3000",
"fax_number": "615-296-6227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "406 E STATE HIGHWAY 243",
"city": "CANTON",
"state": "TX",
"postal_code": "751032409",
"telephone_number": "903-962-7551",
"fax_number": "903-962-7122"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "QUITMAN HOSPITAL LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "AHS EAST TEXAS HEALTH SYSTEM, LLC",
"enumeration_date": "2018-02-10",
"last_updated": "2023-10-01",
"certification_date": "2023-10-01",
"status": "A",
"authorized_official_last_name": "PETROVICH",
"authorized_official_first_name": "STEPHEN",
"authorized_official_middle_name": "C.",
"authorized_official_title_or_position": "EVP",
"authorized_official_telephone_number": "615-296-3000"
},
"taxonomies": [
{
"code": "261QR1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rural Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.