NPIMap

Organization Active NPI

Coryell County Memorial Hospital Authority

  • Skilled Nursing Facility
  • Waco, TX
National Provider Identifier
1043750854
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY
Practice address
1700 Woodgate Dr
Waco, TX 76712-8600
Phone
(254) 666-5454
Fax
(254) 666-5459
NPI assigned
Feb 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1700 Woodgate Dr
Waco, TX 76712-8600

Mailing address

1700 Woodgate Dr
Waco, TX 76712-8600
Phone (254) 666-5454

Other identifiers 1

IdentifierTypeStateIssuer
101740MedicaidTX

Other names 1

  • WESLEY WOODS HEALTH & REHABILITATION Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170710000539 TX Part A Provider - Skilled Nursing Facility 7719886282 Practice locations: Waco, TX

Skilled nursing facility certification: CCN 676211

Legal name
CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY
Doing business as
WESLEY WOODS HEALTH & REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Feb 1, 2009
Last certification
Aug 2, 2023
Beds
120
Ownership / control type
Corporation
Organization structure
OtherNon-profit
Enrollment address
1700 Woodgate Dr
Waco, TX 76712-8600
Nursing home name
WESLEY WOODS HEALTH & REHABILITATION
Affiliated entity
CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY

Care Compare: Nursing home

Medicare Care Compare
Listed as
Wesley Woods Health & RehabilitationCCN 676211
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Feb 1, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120110.2 residents per day on average
Chain
Coryell County Memorial Hospital Authority9 facilities in the chain
Penalties (3 years)
2Fines totaling $55,900

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Demetrios Katsaros39 organizations share this tax ID, including this one

Other organizations with this tax ID 38

Organizations that report the same tax identification number in the National Provider Directory.

View all 38

Locations

1700 Woodgate Dr
Woodway, TX 76712
Phone (254) 420-1123

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Catherine Cook Individual Operational/Managerial Control Dec 1, 2018
David Byrom Individual Corporate DirectorCeo of Hospital District Apr 1, 2017
Managing Control - Governing BodyCeo of Hospital District Dec 1, 2018
Adam David Flowers Individual Operational/Managerial Control Apr 1, 2023
Adp of the SNF Apr 1, 2023
Debra Thomasson Individual Operational/Managerial Control Apr 1, 2023
Adp of the SNF Apr 1, 2023
Coryell County Memorial Hospital Authority Organization, Gatesville, TX Operational/Managerial Control Dec 1, 2018
Adp of the SNF Dec 1, 2018
Woodgate Senior Care LLC Organization, Waco, TX LLC, For-profit Operational/Managerial Control Dec 1, 2018
Adp of the SNF Apr 7, 2025
Jack Cook Individual Operational/Managerial Control Dec 1, 2018
Adp of the SNF Dec 1, 2018

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
Ft Worth Southwest Nursing CenterFort Worth, TX, CCN 675817 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2021
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
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 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

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": "1488153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488153600000",
    "number": "1043750854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 WOODGATE DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767128600",
            "telephone_number": "254-666-5454",
            "fax_number": "254-666-5459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 WOODGATE DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767128600",
            "telephone_number": "254-666-5454",
            "fax_number": "254-666-5459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-27",
        "last_updated": "2017-02-27",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101740",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WESLEY WOODS HEALTH & REHABILITATION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.