JACKSON COUNTY HOSPITAL DISTRICT (NPI# 1073696357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073696357 |
| Entity Type | Organization |
| Organization Name | JACKSON COUNTY HOSPITAL DISTRICT |
| Other Organization Name | JACKSON MEDICAL CLINIC OF GANADO PHYSICIAN GROUP |
| Practice Address |
202 S. Third Street Ganado TX 77962-1214 |
| Mailing Address |
1013 S Wells St Edna TX 77957-4098 |
| Practice Telephone | 3617713571 |
| Practice Fax Number | 3617713574 |
| Mailing Telephone | 3617825241 |
| Mailing Fax Number | 3617827495 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MARCELLA VANA HENKE (ADMINISTRATOR/CEO) |
| Authorized Official Telephone | 3617825241 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| X | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| X | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 85627001 | 05 |
| Other Name | Type Code |
|---|---|
| Jackson Medical Clinic of Ganado Physician Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841371739 | Jackson County Hospital District | Medicare Defined Swing Bed Unit | 1013 S Wells Street, Edna, TX 77957-4098 | 2006-10-18 |
| 1457432460 | Jackson County Hospital District | Internal Medicine | 1013 S Wells St, Edna, TX 77957-4098 | 2006-10-17 |
| 1407892698 | Jackson County Hospital District | Skilled Nursing Facility | 107 E Rogers, Ganado, TX 77962-1204 | 2006-06-22 |
| 1215971478 | Jackson County Hospital District | Emergency Medicine | 1013 S. Wells Street, Edna, TX 77957-4098 | 2006-06-16 |
| 1285677401 | Jackson County Hospital District | Home Health | 918 South Wells Street, Edna, TX 77957-3745 | 2006-06-14 |
| 1346283033 | Jackson County Hospital District | Clinic/Center | 202 S Third Street, Ganado, TX 77962-1214 | 2006-06-13 |
| 1124061882 | Jackson County Hospital District | General Acute Care Hospital | 1013 South Wells Street, Edna, TX 77957-4098 | 2006-06-13 |
| 1992748693 | Jackson County Hospital District | Clinic/Center | 1013a South Wells Street, Edna, TX 77957-4045 | 2006-06-13 |
| 1083035232 | Jackson County Hospital District | Clinic/Center | 4318 5th Ave, Marianna, FL 32446-2182 | 2013-12-13 |
| 1710261573 | Jackson County Hospital District | Ambulance | 1013 S Wells St, Edna, TX 77957-4045 | 2011-09-28 |
| Street Address |
202 S. THIRD STREET |
| City | GANADO |
| State | TX |
| Zip Code | 77962-1214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194349217 | El Campo Memorial Hospital | Internal Medicine | 204 4th Street, Ganado, TX 77962 | 2020-06-04 |
| 1396189635 | Brookshire Brothers Inc | Pharmacy | 305 West York, Ganado, TX 77962 | 2013-04-17 |
| 1811025125 | Ganado Isd | Local Education Agency (LEA) | 211 S. Sixth Street, Ganado, TX 77962 | 2007-02-28 |
| 1346394335 | City of Ganado | Ambulance | 112 E Putnam Ave., Ganado, TX 77962 | 2007-01-23 |
| 1992152649 | Brittney Richelle Cruse | Pharmacist | 305 West York, Ganado, TX 77962 | 2016-05-23 |
| 1033301866 | Ronald D. Kosanke | Physician Assistant | 204 S. 4th Street, Ganado, TX 77962-0000 | 2007-08-15 |
| 1780687251 | Joe Lynn Bonnot | Dentist | 114 S 3rd St, Ganado, TX 77962-0302 | 2005-05-27 |
| 1407892698 | Jackson County Hospital District | Skilled Nursing Facility | 107 E Rogers, Ganado, TX 77962-1204 | 2006-06-22 |
| 1154350296 | W Sam Williams Jr Md Pa | Clinic/Center | 204 South 4th Street, Ganado, TX 77962-1210 | 2006-07-01 |
| 1942231824 | Wilford Samuel Williams | Family Medicine | 204 South 4th Street, Ganado, TX 77962-1210 | 2006-07-06 |
| Find all providers in zip 77962 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194349217 | El Campo Memorial Hospital | Internal Medicine | 204 4th Street, Ganado, TX 77962 | 2020-06-04 |
| 1194960435 | Isaiah L. Ford | Internal Medicine | Arizona Hwy 264 & Hwy 191, Ganado, AZ 86505 | 2008-12-15 |
| 1477537009 | Jonathan H Ostrow | Internal Medicine | Highway 265 West and Junction 191 South, Sage Memorial Hospital, Ganado, AZ 86505 | 2005-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295334936 | Samantha H. Goodman, Md, Pllc | Internal Medicine | 3926 S Treadaway Blvd Ste B2, Abilene, TX 79602-6939 | 2020-10-23 |
| 1750989109 | 3d Regeneration LLC | Internal Medicine | 11610 Bee Caves Rd Ste 230, Austin, TX 78738-5457 | 2020-10-16 |
| 1174121552 | Taiwo Kuye, Md Pa | Internal Medicine | 7135 N Expressway 77 Ste C, Olmito, TX 78575-5204 | 2020-10-16 |
| 1760080014 | Stephanie Kennedy | Internal Medicine | 503 E Sonterra Blvd, San Antonio, TX 78258-4058 | 2020-10-09 |
| 1588262711 | Medicus Internal Medicine & Primary Care Pllc | Internal Medicine | 2822 Dogwood Terrace Ln, Katy, TX 77494-7166 | 2020-10-09 |
| 1588261002 | Cardiac Rhythm Center Pllc | Internal Medicine | 2527 Gramercy St, Houston, TX 77030-3107 | 2020-10-07 |
| 1982210571 | Kim L Rowlands | Internal Medicine | 6101 E Oltorf, None, Austin, TX 78704-7875 | 2020-09-18 |
| 1891301438 | Primary Care of Houston Pllc | Internal Medicine | 19255 Park Row Ste 204b, Houston, TX 77084-7310 | 2020-09-18 |
| 1225644065 | Seton Family of Doctors | Internal Medicine | 3001 Palm Way, D1 : 134-138, Austin, TX 78758 | 2020-09-17 |
| 1528674561 | Knight Doctor Pllc | Internal Medicine | 1401 Eva St Apt 304, Austin, TX 78704-3069 | 2020-09-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.