Lavaca Hospital District
Organization Active NPI Critical Access Hospital · Hallettsville, TX
NPI 1992767511 · NPPES record last updated Oct 20, 2020
Key facts
- NPI
- 1992767511
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- Legal business name
- LAVACA HOSPITAL DISTRICT
- Practice address
- 1400 N Texana
Hallettsville, TX 77964-2021 - Phone
- (361) 798-3671
- Fax
- (361) 798-3128
- NPI assigned
- Apr 6, 2006
- Organization subpart
- No
Authorized official
- Name
- Jack S Bowen
- Title
- Administrator
- Phone
- (361) 798-3671
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 4
Related certifications (CCN) 2
Practitioners 43
-
Christina Awad, M.D.
-
Bradly Bundrant, M.D.
-
Kris A Ford, DPM
-
Morgan Whitney Heck, M.D.
-
Carl Kay, MD
-
Kurtis Ray Krueger, M.D.
-
Allison Nicole McFarland, CRNA
-
David Takuma Nemoto, M.D.
-
Chukuemeka N Odita, M.D.
-
Corey Scruggs, M.D.
-
Kody Selzer, M.D.
-
David B Udall, MD
-
Prameela Yoganandan, M.D.
-
Cody A Walthall, M.D.
-
Rami Ali, MD
-
Van Kaden Andre, MD
-
Andrew Anthony Armondo, CRNA
-
Ramon Omar Cantu, D.O.
Affiliated clinicians 134
-
Ashraf Abusara, MD
-
Abigayle Taylor Adamson, PA-C
-
Ayo Adu, M.D.
-
Rami Ali, MD
-
Saundra Rae Anderson, D.O.
-
Van Kaden Andre, MD
-
Desiree May Arrambide, PA-C
-
Sara Ashraf, M.D.
-
Jonven Attia, MD
-
Christina Awad, M.D.
-
Lisa Baker, F.N.P.-C
-
Heather E. Banks, M.D.
-
Hector Miguel Barron, APRN, FNP-C
-
Bruce Bauknight, MD
-
Wess James Blackwell, M.D.
-
Thomas O Borgstedte, D.O.
-
Kendall Kristynik Brandt, DNP, FNP-C
-
Rosemary Buckle, M.D.
-
Bradly Bundrant, M.D.
-
Angela Burgin, FNP-C
Medicare Care Compare: Hospital
- Listed as
- Lavaca Medical Center
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Critical Access Hospitals
- Ownership
- Government - Hospital District or Authority
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Hospital certification: CCN 451376
- Legal name
- LAVACA HOSPITAL DISTRICT
- Doing business as
- LAVACA MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Dec 29, 2005
- Last certification
- Sep 19, 2023
- Beds
- 25
- Ownership / control type
- Hospital district or authority
- Organization structure
- Other · Non-profit
- Enrollment address
- 1400 N Texana St
Hallettsville, TX 77964-2021
All disclosed owners & managing parties 2
| Name | Role | Since | Share |
|---|---|---|---|
| Tracy Green |
Corporate Director | Apr 27, 2015 | |
| W-2 Managing Employee | Apr 27, 2015 | ||
| Jack Bowen |
Corporate Officer | Jul 22, 2015 | |
| W-2 Managing Employee | Jul 22, 2015 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061104000500 | TX | Part a Provider - Critical Access Hospital | 1153211750 |
Receives reassigned benefits from 38 practitioners Practice locations: Hallettsville, TX |
National Provider Directory
- Tax ID family
- Lavaca Family Health CL
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | Yes |
Addresses
Primary practice location
1400 N Texana
Hallettsville, TX 77964-2021
Mailing address
1400 N Texana
Hallettsville, TX 77964-2021
Phone (361) 798-3671
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 135233809 | Medicaid | TX |
Other names
- Lavaca Medical Center
Other providers in Hallettsville, TX
- Lavaca County Senior Citizens Program
- Lavaca Family Health Clinic
- Lavaca Hospital District
- Lavaca Hospital District
- Lavaca Hospital District
- Mandie Lozano
- Yvette Massey
- Kelly Matthew-Gil
- Terri McGee
- Tristan Meisetschleager
All providers in Hallettsville, TX · Critical Access Hospital in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.