Walker County Hospital Corporation

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

WALKER COUNTY HOSPITAL CORPORATION

Practice address

125 Medical Park LN Ste C
Huntsville, TX 77340-4957

Phone

(936) 291-3219

Fax

(936) 291-7206

NPI assigned

Mar 20, 2007

Organization subpart

Yes

Parent organization

WALKER COUNTY HOSPITAL CORPORATIONAs reported in NPPES

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

Authorized official

Name

Mr. John Moore

Title

Cfo

Phone

(936) 435-3411

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Huntsville Memorial Hospital Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Part of

Walker County Hospital Corp

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Huntsville Community Hospital, Inc.

  • Rural Health Clinic/Center
  • Huntsville, TX
  • NPI 1306484050

  Sold to, 2020-02-28

  CMS change of ownership

Practitioners 1

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

• Kristina L. Mullen, PAC

  • Surgical Physician Assistant
  • Mount Vernon, WA
  • NPI 1588757306
  NPD (past)

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553731200000",
    "number": "1972628816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MEMORIAL HOSPITAL DRIVE",
            "address_2": "REVENUE CYCLE",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773404957",
            "telephone_number": "936-439-1440",
            "fax_number": "936-435-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 MEDICAL PARK LN STE C",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773404957",
            "telephone_number": "936-291-3219",
            "fax_number": "936-291-7206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALKER COUNTY HOSPITAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALKER COUNTY HOSPITAL CORPORATION",
        "enumeration_date": "2007-03-20",
        "last_updated": "2019-03-28",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "936-435-3411",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107642401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Huntsville Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Walker County
• Walker County Hospital Corporation
• Walker County Hospital Corporation
• Walker County Hospital Corporation
• Walker County Hospital Corporation
• Fred Eugene Walker II, PHARMD
• Martel Walker
• Tiffany Walla, MS, RD, LD
• Benjamin Levi Wallace, FNP-C
• Katie Waller, LCDC

• Rural Health Clinic/Center in Huntsville, TX
• Providers in Huntsville, TX by specialty
• Rural Health Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; 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.

Verify at the official NPI Registry.