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Jackson County Hospital District

Organization Active NPI Rural Health Clinic/Center · Edna, TX

NPI 1992748693 · NPPES record last updated Apr 28, 2025

Key facts

NPI
1992748693
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
JACKSON COUNTY HOSPITAL DISTRICT
Practice address
1013A South Wells Street
Edna, TX 77957-4045
Phone
(361) 782-3560
Fax
(361) 782-5627
NPI assigned
Jun 13, 2006
Organization subpart
No

Authorized official

Name
Lance Harrison Smiga
Title
Administrator/Cfo
Phone
(361) 782-7800

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Owned or controlled facilities with NPI records 4

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

Other NPIs on the same Medicare enrollment 2

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

Other NPIs with the same Medicare PAC ID 6

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

Corporate family (same tax ID) 11

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

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

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 20

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in TX

Rural health clinic certification: CCN 458736

Legal name
JACKSON COUNTY HOSPITAL DISTRICT
Doing business as
JACKSON COUNTY MEDICAL CLINIC OF EDNA
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 20, 1997
Last certification
Jun 28, 2024
Ownership / control type
Non-profit – church related
Organization structure
Other · Proprietary
Incorporated
Jan 1, 2005 in TX
Enrollment address
1013A S Wells St
Edna, TX 77957-4045
Related CCNs
451363

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
Jackson County Hospital District
Organization · Edna, TX 		5% Or Greater Direct Ownership Interest Jan 1, 2005 100%
Lance Smiga
Individual 		Corporate Officer
Cfo		 Jul 1, 2012 100%
W-2 Managing Employee
Cfo		 Jul 1, 2012 100%
Paula Gabrysch
Individual 		Corporate Director
Supervisor		 Jan 1, 2010 100%
W-2 Managing Employee
Supervisor		 Jan 1, 2010 100%

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Jackson Healthcare Center
Edna, TX · CCN 451363		 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2005
Jackson Healthcare Center
Edna, TX · CCN 45Z363		 Hospital 5% Or Greater Direct Ownership Interest Jan 1, 2005
Jackson County Home Health
Edna, TX · CCN 677103		 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 31, 2011
Oct 31, 2011
Jackson County Medical Clinic of Ganado
Ganado, TX · CCN 673495		 Rural health clinic Operational/Managerial Control Oct 1, 2025

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040601000224 TX Part B Supplier - Clinic/Group Practice 2365423795 Receives reassigned benefits from 99 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Edna, TX
O20100521000120 TX Part a Provider - Rural Health Clinic 2365423795 Practice locations: Edna, TX

National Provider Directory

Tax ID family
Edna Family Practice (12 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Yes

Addresses

Primary practice location

1013A South Wells Street
Edna, TX 77957-4045

Mailing address

1013 S Wells Street
Edna, TX 77957-4098
Phone (361) 782-7800

Other identifiers

IdentifierTypeStateIssuer
063595501MedicaidTX

Other names

  • Jackson Medical Clinic of Edna Doing business as

Other providers in Edna, TX

All providers in Edna, TX · Rural Health Clinic/Center in Texas

Sources for this page

Verify at the official NPI Registry.