Organization Active NPI

Everest Rehabilitation Hospital Keller, LLC

Doing business as Texas Rehabilitation Hospital of Keller

  • Rehabilitation Hospital
  • Keller, TX
National Provider Identifier
1033759832
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
Legal business name
EVEREST REHABILITATION HOSPITAL KELLER, LLC
Doing business as
Texas Rehabilitation Hospital of Keller
Practice address
791 S Main Street
Keller, TX 76248
Phone
(817) 562-9700
Fax
(817) 562-9701
NPI assigned
Jan 9, 2020
Last updated
Apr 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Authorized official

Name
Jacob Daggett
Title
Market Ceo
Phone
(817) 820-3464

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X NU Primary

Addresses

Primary practice location

791 S Main Street
Keller, TX 76248

Mailing address

791 S Main Street
Keller, TX 76248
Phone (817) 562-9700

Other names 1

  • Texas Rehabilitation Hospital of Keller Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200820002809 TX Part A Provider - Hospital 3870919830 Practice locations: Keller, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033759832. Details of each certification follow.

Hospital certification: CCN 673077

Legal name
EVEREST REHABILITATION HOSPITAL KELLER, LLC
Doing business as
TEXAS REHABILITATION HOSPITAL OF KELLER
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
Feb 16, 2021
Last certification
Feb 16, 2021
Beds
36
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Nov 27, 2017 in TX
Enrollment address
791 S Main Street
Keller, TX 76248-4905
Main/Primary Hospital Location
Hospital subgroups
Rehabilitation

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Texas Rehabilitation Hospital of KellerCCN 673077 · All quality measures
Ownership
For profit
Certified
Feb 16, 2021
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2186216Everest Rehabilitation Hospital of Keller, LLC791 S Main St, Keller, TX 76248Certificate of waiverJun 14, 2028

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Sharon S Smeltzer Individual Corporate DirectorBoard Member Mar 1, 2023
CRH of Fort Worth LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2021 70%
Lifepoint Rehab Blocker LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2021 8.16%
Jacob B Daggett Individual Operational/Managerial ControlCeo / Hospital Administrator Nov 10, 2021
CHC Management Services LLC Organization, Brentwood, TN LLC, Management services company, For-profit Operational/Managerial Control Mar 1, 2021
Lifepoint Rehab LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2021 70%
DSB Acquisition LLC Organization, New York, NY LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2021 70%
Lifepoint Health Inc Organization, Brentwood, TN Corporation, For-profit, Chain home office 5% Or Greater Indirect Ownership Interest Dec 23, 2021 70%
Texas Rehabilitation Hospital of Fort Worth, LLC Organization, Louisville, KY LLC, For-profit 5% Or Greater Direct Ownership Interest Mar 1, 2021 100%
Marcus B Poppell Individual OtherVice President Dec 23, 2021
Naomi Roberts Individual Corporate DirectorBoard Member May 13, 2024
Texas Health Harris Methodist Hospital Fort Worth Organization, Arlington, TX Non-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2021 30%
Russell a Bailey Individual Corporate OfficerPresident, KRS Mar 1, 2021
Centerre Healthcare LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2021 70%
Lifepoint Rehab Blocker Parent LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2021 61.83%

Owners & managing parties with NPI records 3

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

Facilities with the same owner 70

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

View all 70

Practitioners & affiliated clinicians

Practitioners 2

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 5

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": "1578528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1033759832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "791 S MAIN STREET",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "76248",
            "telephone_number": "817-562-9700",
            "fax_number": "817-562-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "791 S MAIN STREET",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "76248",
            "telephone_number": "817-562-9700",
            "fax_number": "817-562-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVEREST REHABILITATION HOSPITAL KELLER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-09",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "DAGGETT",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "MARKET CEO",
        "authorized_official_telephone_number": "817-820-3464"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Texas Rehabilitation Hospital of Keller",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Texas Rehabilitation Hospital of Keller",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Keller, TX

Sources for this page

Verify at the official NPI Registry.