JACK COUNTY HOSPITAL DISTRICT (NPI# 1154419612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154419612 |
| Entity Type | Organization |
| Organization Name | JACK COUNTY HOSPITAL DISTRICT |
| Other Organization Name | FAITH COMMUNITY HOSPITAL AMB SURG |
| 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 | 2006-10-10 |
| Last Update Date | 2017-06-23 |
| Authorized Official Name | MS. KIM LEE (COO) |
| Authorized Official Telephone | 9405676633 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
119874903 | TX | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 119874903 | 05 |
| Other Name | Type Code |
|---|---|
| faith community hospital amb surg | 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 |
| 1790865293 | Jack County Hospital District | Medicare Defined Swing Bed Unit | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2006-10-17 |
| 1336237890 | Jack County Hospital District | Ambulance | 717 Magnolia St, Jacksboro, TX 76458-1111 | 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 |
| 1790865293 | Jack County Hospital District | Medicare Defined Swing Bed Unit | 215 Chisholm Trl, Jacksboro, TX 76458-1403 | 2006-10-17 |
| 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 | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194326785 | Texas Partners Center | Clinic/Center | 3304 Colorado Blvd Ste 203, Denton, TX 76210-6873 | 2020-11-02 |
| 1730789231 | Zeo Surgical Center LLC | Clinic/Center | 4511 Horizon Hill Blvd Ste 100, San Antonio, TX 78229-2399 | 2020-10-26 |
| 1194323725 | Mission Surgery Center LLC | Clinic/Center | 603 E Amber St, Suite 103, San Antonio, TX 78221-7822 | 2020-10-15 |
| 1083211809 | Forest Landing Surgical Center LLC | Clinic/Center | 9303 New Trails Dr Ste 185, The Woodlands, TX 77381-5009 | 2020-10-05 |
| 1457968430 | Park Ventura Endoscopy Center, LLC | Clinic/Center | 981 State Highway 121, Suite 2100, Allen, TX 75013 | 2020-09-24 |
| 1851904056 | Zenith Surgery Center | Clinic/Center | 10710 Kuykendahl Rd Ste 160, The Woodlands, TX 77381-2695 | 2020-08-26 |
| 1063024719 | Horizon Surgery Center | Clinic/Center | 2813 Smith Ranch Rd Ste 180, Pearland, TX 77584-5254 | 2020-08-22 |
| 1376151944 | Rhythm Endovascular & Heart Asc LLC | Clinic/Center | 5418 N Loop 1604 W Ste 250, San Antonio, TX 78249-1207 | 2020-07-20 |
| 1720603079 | Texas Health Surgery Center Chisholm Trail, LLC | Clinic/Center | 5900 Altamesa Blvd, Fort Worth, TX 76132-5473 | 2020-06-12 |
| 1831714419 | Encor Asc, LLC | Clinic/Center | 103 Whispering Winds Dr, Gunter, TX 75058-2560 | 2020-06-10 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on JACK COUNTY HOSPITAL DISTRICT.
| 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.