NPIMap

Organization Active NPI

Memorial Hermann Rehabilitation Hospital Katy, LLC

Doing business as Memorial Hermann Rehabilitation Hospital Katy

  • Rehabilitation Hospital
  • Katy, TX
National Provider Identifier
1043457583
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
Legal business name
MEMORIAL HERMANN REHABILITATION HOSPITAL KATY, LLC
Doing business as
Memorial Hermann Rehabilitation Hospital Katy
Practice address
21720 Kingsland Blvd Ste 102
Katy, TX 77450-2551
Phone
(713) 338-4127
Fax
(713) 338-4158
NPI assigned
Jan 20, 2009
Last updated
Apr 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Authorized official

Name
Ms. Deborah Gordon
Title
Evp, Cao & Chief Legal Officer
Phone
(713) 242-2709

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X
Rehabilitation Hospital 283X00000X Primary

Addresses

Primary practice location

21720 Kingsland Blvd Ste 102
Katy, TX 77450-2551

Mailing address

PO Box 301536
Dallas, TX 75303-1536
Phone (713) 338-4127

Other identifiers 1

IdentifierTypeStateIssuer
220238402MedicaidTX

Other names 1

  • Memorial Hermann Rehabilitation Hospital Katy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090219000299 TX Part A Provider - Hospital 4082779400 Practice locations: Katy, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043457583. Details of each certification follow.

Hospital certification: CCN 673038

Legal name
MEMORIAL HERMANN REHABILITATION HOSPITAL KATY, LLC
Doing business as
MEMORIAL HERMANN REHABILITATION HOSPITAL KATY
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
May 8, 2009
Last certification
Nov 15, 2024
Beds
118
Ownership / control type
Physician ownership
Organization structure
LLCProprietary
Incorporated
Dec 2, 2008 in TX
Enrollment address
21720 Kingsland Blvd
Ste 102
Katy, TX 77450-2551
Main/Primary Hospital Location
Hospital subgroups
Rehabilitation

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Memorial Hermann Rehabilitation Hospital KatyCCN 673038 · All quality measures
Ownership
Physician
Certified
May 8, 2009
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

21720 Kingsland Blvd
Fl 1
Katy, TX 77450
Phone (281) 579-5525

21720 Kingsland Blvd
Ste 304
Katy, TX 77450
Phone (281) 579-5708

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
Memorial Hermann Health System Organization, Houston, TX Non-profit 5% Or Greater Indirect Ownership Interest Apr 1, 2009
James J McCarthy Individual Corporate DirectorBoard Member Mar 29, 2018
W-2 Managing EmployeeExecutive Vice President Mar 29, 2018
Theresa Ancelet Pappas Individual Corporate OfficerVP Revenue Cycle Oct 1, 2025
MH Katy Rehab Hospital, LLC Organization, Houston, TX For-profit 5% Or Greater Direct Ownership Interest May 8, 2009 74.68%
Paul E Bing Individual Corporate DirectorBoard Member Apr 15, 2009
Heath Rushing Individual Corporate OfficerBoard Secretary Oct 15, 2017
W-2 Managing Employee Oct 15, 2017
Mary Ann Euliarte Individual Corporate OfficerBoard Treasurer Mar 29, 2018
W-2 Managing EmployeeChief Nursing Officer,Memorial H Apr 1, 2012
Max Reynolds Individual Corporate OfficerSVP Chief Legal Officer Jun 1, 2025
Ira L Flax Individual Corporate DirectorBoard Member Aug 30, 2018
Charmaine Ferguson Individual W-2 Managing EmployeeAvp Associate General Counsel Aug 1, 2018
Jerry a Ashworth Individual Corporate OfficerBoard Secretary Mar 29, 2018
W-2 Managing EmployeeCeo - Memorial Hermann Katy Rehab Nov 1, 2017
Moo J Chung Individual Corporate DirectorBoard Member Oct 15, 2017
Erin Asprec Individual W-2 Managing EmployeeExecutive Vice President Aug 1, 2018
David W Reininger Individual Corporate DirectorBoard Member Oct 15, 2017
David L Callender Individual Corporate OfficerPresident Sep 1, 2019
W-2 Managing EmployeeChief Executive Officer Sep 1, 2019

Owners & managing parties with NPI records 19

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

View all 19

Facilities with the same owner 13

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

View all 13

Practitioners & affiliated clinicians

Practitioners 8

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 167

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

View all 167

NPI Registry JSON

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

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680566400000",
    "number": "1043457583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 301536",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753031536",
            "telephone_number": "713-338-4127",
            "fax_number": "713-338-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21720 KINGSLAND BLVD STE 102",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774502551",
            "telephone_number": "713-338-4127",
            "fax_number": "713-338-4158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HERMANN REHABILITATION HOSPITAL KATY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-20",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "EVP, CAO & CHIEF LEGAL OFFICER",
        "authorized_official_telephone_number": "713-242-2709",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220238402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Hermann Rehabilitation Hospital Katy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memorial Hermann Rehabilitation Hospital Katy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.