NPIMap

Organization Active NPI

Coryell County Memorial Hospital Authority

Doing business as Ft Worth Southwest Nursing Center

  • Skilled Nursing Facility
  • Fort Worth, TX
National Provider Identifier
1023407012
Registry record updated Jan 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY
Doing business as
Ft Worth Southwest Nursing Center
Practice address
5300 Altamesa Blvd
Fort Worth, TX 76133-5924
Phone
(817) 346-1800
Fax
(817) 346-0149
NPI assigned
Jan 14, 2015
Last updated
Jan 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David K Byrom
Title
Ceo
Phone
(254) 248-6300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

5300 Altamesa Blvd
Fort Worth, TX 76133-5924

Mailing address

5300 Altamesa Blvd
Fort Worth, TX 76133-5924
Phone (817) 346-1800

Other identifiers 1

IdentifierTypeStateIssuer
005197MedicaidTX

Other names 1

  • FT WORTH SOUTHWEST NURSING CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150330001004 TX Part A Provider - Skilled Nursing Facility 7719886282 Practice locations: Fort Worth, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023407012. Details of each certification follow.

Skilled nursing facility certification: CCN 675817

Legal name
CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY
Doing business as
FT WORTH SOUTHWEST NURSING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Jan 28, 2000
Last certification
Feb 5, 2025
Beds
198
Ownership / control type
Hospital District
Organization structure
GovernmentNon-profit
Enrollment address
5300 Altamesa Blvd
Fort Worth, TX 76133-5924
Nursing home name
FT WORTH SOUTHWEST NURSING CENTER
Affiliated entity
OPCO SKILLED MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Ft. Worth Southwest Nursing CenterCCN 675817 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 28, 2000
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
198143.1 residents per day on average
Chain
Opco Skilled Management66 facilities in the chain
Penalties (3 years)
1Fines totaling $23,923

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Continuum Rehab Group LLC Organization, Los Angeles, CA LLC Adp of the SNF Dec 1, 2021
Kristi M Blackwell Individual Adp of the SNF Sep 30, 2024
Opco Ca Skilled MGMT Inc. Organization, Los Angeles, CA Corporation Adp of the SNF Dec 1, 2021
Opco Texas Skilled MGMT LLC Organization, Los Angeles, CA LLC Adp of the SNF Dec 1, 2021
Southwest Nursing & Rehab Center, LLC Organization, Los Angeles, CA LLC Operational/Managerial Control Dec 1, 2021
David Byrom Individual Corporate OfficerCeo Mar 1, 2015
Rachel S Villegas Individual Adp of the SNF Mar 14, 2018
Coryell County Memorial Hospital Authority Organization, Gatesville, TX 5% Or Greater Direct Ownership Interest Dec 1, 2021 100%
David Garetz Individual Operational/Managerial Control Dec 1, 2021
Magnolia Realty, LLC Organization, Los Angeles, CA LLC Adp of the SNF Dec 1, 2021
5300 Alta Mesa Blvd, LLC Organization, Los Angeles, CA LLC Adp of the SNF Dec 1, 2021

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 31

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

FacilityTypeRoleSince
Coryell Health Rehabliving at the MeadowsGatesville, TX, CCN 675886 Skilled nursing facility Operational/Managerial Control Jan 20, 2025
Copperas Hollow Nursing and Rehabilitation CenterCaldwell, TX, CCN 676227 Skilled nursing facility Operational/Managerial Control Jan 1, 2014
Colonial Manor Nursing CenterCleburne, TX, CCN 455631 Skilled nursing facility 5% Or Greater Indirect Ownership Interest Sep 1, 2014
Granbury Rehab & NursingGranbury, TX, CCN 455929 Skilled nursing facility Operational/Managerial Control Sep 1, 2014
Ivy Creek Wellness & RehabilitationWaco, TX, CCN 455478 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 2, 2024
Windsor Healthcare ResidenceGroesbeck, TX, CCN 675139 Skilled nursing facility Operational/Managerial Control Oct 1, 2014
Western Hills Healthcare ResidenceComanche, TX, CCN 455602 Skilled nursing facility Operational/Managerial Control Oct 1, 2019
The Manor Healthcare ResidenceMexia, TX, CCN 675307 Skilled nursing facility Operational/Managerial Control Oct 1, 2014
Fairview Healthcare ResidenceFairfield, TX, CCN 675311 Skilled nursing facility Operational/Managerial Control Oct 1, 2014
Crestview Heatlhcare ResidenceWaco, TX, CCN 675141 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2019
Brentwood Place ThreeDallas, TX, CCN 675352 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2021
Brentwood Place TwoDallas, TX, CCN 675702 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2021
Brentwood Place OneDallas, TX, CCN 675680 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2021
West Side Campus of CareWhite Settlement, TX, CCN 455592 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2017
New Hope ManorCedar Park, TX, CCN 675943 Skilled nursing facility Operational/Managerial Control Apr 1, 2017
Gracy Woods II Living CenterAustin, TX, CCN 675914 Skilled nursing facility Operational/Managerial Control Apr 1, 2017
Advanced Rehabilitation and Healthcare of AthensAthens, TX, CCN 675424 Skilled nursing facility 5% Or Greater Indirect Ownership Interest Apr 1, 2017
Winfield Rehab & NursingCrockett, TX, CCN 675976 Skilled nursing facility 5% Or Greater Indirect Ownership Interest Apr 1, 2017
Whitehall Rehab & NursingCrockett, TX, CCN 675624 Skilled nursing facility 5% Or Greater Indirect Ownership Interest Apr 1, 2017
Wesley Woods Health & RehabilitationWaco, TX, CCN 676211 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 1, 2018
Dec 1, 2018
Ft Worth Wellness & RehabilitationFt Worth, TX, CCN 455457 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Aug 16, 2018
Glenview Wellness & RehabilitationRichard Hills, TX, CCN 455494 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Aug 16, 2018
Bedford Wellness & RehabilitationBedford, TX, CCN 455798 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Aug 16, 2018
Austin Wellness & RehabilitationAustin, TX, CCN 455799 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Aug 16, 2018
Bluebonnet Rehab at EnnisEnnis, TX, CCN 675150 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 17, 2019
Woodway Rehabilitation and Healthcare CenterWaco, TX, CCN 675924 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Apr 1, 2020
Apr 22, 2025
Hico Nursing and RehabilitationHico, TX, CCN 675468 Skilled nursing facility Operational/Managerial Control Apr 1, 2022
Hillside Medical LodgeGatesville, TX, CCN 675201 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2025
Coryell Home HealthGatesville, TX, CCN 457668 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jul 24, 1984
Mills County Medical ClinicGoldthwaite, TX, CCN 458530 Rural health clinic Operational/Managerial Control Feb 11, 2010
Coryell Health Medical Clinic MoodyMoody, TX, CCN 678556 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 28, 1975

Facilities with the same owner 31

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

View all 31

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1421193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611360000000",
    "number": "1023407012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 ALTAMESA BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761335924",
            "telephone_number": "817-346-1800",
            "fax_number": "817-346-0149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 ALTAMESA BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761335924",
            "telephone_number": "817-346-1800",
            "fax_number": "817-346-0149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-14",
        "last_updated": "2021-01-23",
        "certification_date": "2021-01-23",
        "status": "A",
        "authorized_official_last_name": "BYROM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "254-248-6300"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005197",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FT WORTH SOUTHWEST NURSING CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FT WORTH SOUTHWEST NURSING CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.