JACK COUNTY HOSPITAL DISTRICT (NPI# 1790865293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790865293 |
| Entity Type | Organization |
| Organization Name | JACK COUNTY HOSPITAL DISTRICT |
| Other Organization Name | FAITH COMMUNITY HOSPITAL |
| Practice Address |
215 Chisholm Trl Jacksboro TX 76458-1403 |
| Practice Telephone | 9405676633 |
| Practice Fax Number | 9405672895 |
| Mailing Telephone | (940) 567-6633 |
| Mailing Fax Number | 9405672895 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2017-06-29 |
| Authorized Official Name | MRS. KIM LEE (COO) |
| Authorized Official Telephone | 9405676633 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 275N00000X | Medicare Defined Swing Bed Unit | 45U241 | TN | Hospital Units |
| Y | 275N00000X | Medicare Defined Swing Bed Unit | 100322 | TX | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | NPI | 1790865293 | 01 |
| Other Name | Type Code |
|---|---|
| FAITH COMMUNITY HOSPITAL | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790777696 | Jack County Hospital District | Family Medicine | 215 Chisholm Trl, Jacksboro, TX 76458 | 2005-08-17 |
| 1235737008 | Jack County Hospital District | Clinic/Center | 1005 State Highway 16 S, Graham, TX 76450-3835 | 2020-10-14 |
| 1831674209 | Jack County Hospital District | Clinic/Center | 115 E Bypass 287, Alvord, TX 76225-7778 | 2018-10-01 |
| 1417489956 | Jack County Hospital District | Clinic/Center | 1010 N Mill St, Bowie, TX 76230-3120 | 2017-04-03 |
| 1316341407 | Jack County Hospital District | Skilled Nursing Facility | 3301 View St, Fort Worth, TX 76103-2425 | 2014-10-17 |
| 1205239266 | Jack County Hospital District | Skilled Nursing Facility | 501 N Main St, Collinsville, TX 76233-5106 | 2014-10-06 |
| 1376977017 | Jack County Hospital District | Skilled Nursing Facility | 405 Duncan Perry Rd, Arlington, TX 76011-5412 | 2013-08-29 |
| 1336237890 | Jack County Hospital District | Ambulance | 717 Magnolia St, Jacksboro, TX 76458-1111 | 2006-10-10 |
| 1154419612 | Jack County Hospital District | Clinic/Center | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2006-10-10 |
| 1396798583 | Jack County Hospital District | Skilled Nursing Facility | 211 E Jasper St, Jacksboro, TX 76458-1848 | 2006-05-18 |
| Street Address |
215 CHISHOLM TRL |
| City | JACKSBORO |
| State | TX |
| Zip Code | 76458-1403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790777696 | Jack County Hospital District | Family Medicine | 215 Chisholm Trl, Jacksboro, TX 76458 | 2005-08-17 |
| 1316418809 | Robert Cooper, M.d., Pa | Family Medicine | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2018-12-10 |
| 1336651710 | Global Family Practice, Pllc | Family Medicine | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2017-10-25 |
| 1841660560 | Becky Matlock | Counselor | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2015-10-07 |
| 1598146433 | Mackenzi Eberly | Nurse Practitioner | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2015-06-16 |
| 1780927707 | Robert Cooper | Family Medicine | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2013-03-27 |
| 1710117833 | Debbie Lynn Young | Nurse Practitioner | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2009-07-23 |
| 1518109040 | Lara Marina Pierce | Family Medicine | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2009-03-30 |
| 1164687620 | Brent Shepherd | Family Medicine | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2008-07-24 |
| 1154419612 | Jack County Hospital District | Clinic/Center | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2006-10-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598274128 | Suzzan Bea Fleming | Nurse Practitioner | 1620 Fm 3344, Jacksboro, TX 76458 | 2017-09-27 |
| 1437157419 | Syed M Jamal | Internal Medicine | 717 Magnolia St, Jacksboro, TX 76458-1111 | 2005-07-13 |
| 1144629197 | Mackenzie Prince | Registered Nurse | 717 Magnolia St, Jacksboro, TX 76458-1111 | 2014-08-15 |
| 1093997785 | Babu Hosakote Subrahmanyam | Family Medicine | 717 Magnolia St, Jacksboro, TX 76458-1111 | 2007-12-04 |
| 1336237890 | Jack County Hospital District | Ambulance | 717 Magnolia St, Jacksboro, TX 76458-1111 | 2006-10-10 |
| 1104818723 | Faith Community Hospital Home Health | Home Health | 717 Magnolia St, Jacksboro, TX 76458-1111 | 2005-08-19 |
| 1003965260 | Graham Regional Medical Center | General Acute Care Hospital | 611 N 4th St, Jacksboro, TX 76458-1113 | 2007-01-09 |
| 1417081688 | Graham Regional Medical Center | General Acute Care Hospital | 611 N 4th St, Jacksboro, TX 76458-1113 | 2007-03-16 |
| 1376043877 | Ashley Mae Chitwood | Licensed Vocational Nurse | 606 N 6th St, Jacksboro, TX 76458-1117 | 2018-02-20 |
| 1457657371 | Physician Services of Jacksboro Pa | Internal Medicine | 709 N 4th St, Jacksboro, TX 76458-1132 | 2011-02-10 |
| Find all providers in zip 76458 | ||||
| Taxonomy Code | 275N00000X |
| Grouping | Hospital Units |
| Classification | Medicare Defined Swing Bed Unit |
| A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
| Notes: Source: Code of Federal Regulations #42, Section 482.66. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508214222 | Trinity Diagnostic Clinic, P.a | Medicare Defined Swing Bed Unit | 6324 Southern Hills Dr, Fort Worth, TX 76132-4485 | 2016-06-03 |
| 1710224647 | Caroline Chioma Ukachukwu | Medicare Defined Swing Bed Unit | 6565 Fannin St. Mgj. Suit 11, The Methodist Hospital, Mary Gibbs, Houston, TX 77030 | 2013-01-11 |
| 1023353752 | Eastland Memorial Hospital District | Medicare Defined Swing Bed Unit | 304 South Daugherty Street, Eastland, TX 76448 | 2012-12-06 |
| 1447574819 | Frio Hospital Association | Medicare Defined Swing Bed Unit | 200 S Ih 35, Pearsall, TX 78061-6601 | 2010-03-15 |
| 1952567588 | Preferred Hospital Leasing Junction, Inc | Medicare Defined Swing Bed Unit | 349 Reid Rd, Junction, TX 76849-3049 | 2008-08-04 |
| 1699939421 | Preferred Hospital Leasing Hemphill, Inc. | Medicare Defined Swing Bed Unit | 2301 State Highway 83w, Hemphill, TX 75948-0750 | 2008-07-10 |
| 1801087630 | Mitchell County Hospital District | Medicare Defined Swing Bed Unit | 997 West I-20, Colorado City, TX 79512 | 2007-08-07 |
| 1023138781 | Throckmorton County Memorial Hosp | Medicare Defined Swing Bed Unit | 802 N. Minter Ave., Throckmorton, TX 76483-5357 | 2007-03-29 |
| 1093839839 | Muenster Hospital District | Medicare Defined Swing Bed Unit | 605 N Maple, Muesnter, TX 76252-2424 | 2007-03-19 |
| 1841371739 | Jackson County Hospital District | Medicare Defined Swing Bed Unit | 1013 S Wells Street, Edna, TX 77957-4098 | 2006-10-18 |
| 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.