NPIMap

Organization Active NPI

St. Joseph Regional Health Center

Doing business as CHI St. Joseph Health College Station Hospital

  • General Acute Care Hospital
  • College Station, TX
National Provider Identifier
1053963009
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
ST. JOSEPH REGIONAL HEALTH CENTER
Doing business as
CHI St. Joseph Health College Station Hospital
Practice address
1604 Rock Prairie Rd
College Station, TX 77845-8345
Phone
(979) 764-5100
NPI assigned
Jul 10, 2019
Last updated
Jul 10, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Authorized official

Name
Theron Park
Title
Authorized Official
Phone
(979) 776-2599

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

1604 Rock Prairie Rd
College Station, TX 77845-8345

Mailing address

2801 Franciscan Dr
Bryan, TX 77802-2544
Phone (979) 776-2478

Other names 1

  • CHI St. Joseph Health College Station Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080206000156 TX Part A Provider - Hospital 5294727921 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bryan, TX; College Station, TX; Brenham, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053963009. Details of each certification follow.

Hospital certification: CCN 450011

Legal name
ST JOSEPH REGIONAL HEALTH CENTER
Doing business as
CHI ST JOSEPH HEALTH REGIONAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 22, 2024
Beds
316
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Mar 13, 1959 in TX
Enrollment address
2801 Franciscan Dr
Bryan, TX 77802-2544
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
CHI St Joseph Health Regional HospitalCCN 450011 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
St Joseph Regional RehabCCN 45T011
Ownership
Non-profit
Certified
Dec 30, 1997

This is a unit of this hospital with its own CMS Certification Number. Care Compare reports it separately, and it has no NPI of its own. How units are connected

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Gary Whitlock Individual Corporate Director Jun 30, 2021
St. Lukes Health System Corporation Organization, Houston, TX Corporation 5% Or Greater Indirect Ownership Interest Jun 12, 2019
Commonspirit Health Organization, Chicago, IL Non-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2014 100%
Robert Upchurch Individual Corporate DirectorBoard of Directors Jun 30, 2021
Matthew Brown Individual Corporate OfficerPresident Jul 1, 2025
Corporate DirectorBoard Member Jul 1, 2025
Frank Ashley Individual Corporate DirectorBoard Member Jun 30, 2021
Terika Richardson Mbanu Individual Corporate DirectorBoard Member Jul 1, 2025
Donald D Hearne Individual Corporate OfficerSecretary Jul 1, 2025
Brooks Bass Individual Corporate Director Jun 30, 2021
Brad Beers Individual Corporate Director Jun 30, 2021
Thomas Kopfensteiner Individual Corporate DirectorBoard Member Jul 1, 2025
Shelli D Brooks Individual Corporate OfficerMRKT VP Operational Finance Sep 1, 2025
Operational/Managerial ControlMRKT VP Operational Finance Sep 1, 2025
St Joseph Regional Health Center Organization, Bryan, TX Corporation, For-profit 5% Or Greater Direct Ownership Interest Jun 30, 2021 100%
Operational/Managerial Control Jun 30, 2021 100%
Jane Ainsworth Individual Corporate Director Jun 30, 2021
Monte J Bostwick Individual Corporate DirectorAdvisory Board Member Jul 1, 2025
Operational/Managerial ControlMarket President Jul 1, 2025
Indira S Anupindi Individual Corporate Director Jun 30, 2021
Demetress L Harrell Individual Corporate Director Jun 30, 2021
St Lukes Health Clinical Operations Organization, Houston, TX Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jun 30, 2021 100%

Owners & managing parties with NPI records 5

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

Practitioners & affiliated clinicians

Affiliated clinicians 548

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

View all 548

NPI Registry JSON

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562716800000",
    "number": "1053963009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 FRANCISCAN DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022544",
            "telephone_number": "979-776-2478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 ROCK PRAIRIE RD",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458345",
            "telephone_number": "979-764-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH REGIONAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-07-10",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "THERON",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "979-776-2599"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHI St. Joseph Health College Station Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.