NPIMap

Organization Active NPI

Hendrick Medical Center

Doing business as Hendrick Skilled Nursing Facility

  • Skilled Nursing Facility
  • Abilene, TX
National Provider Identifier
1063418937
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
000500 Issued in TX
Legal business name
HENDRICK MEDICAL CENTER
Doing business as
Hendrick Skilled Nursing Facility
Practice address
1900 Pine St
Abilene, TX 79601-2432
Phone
(325) 670-2000
NPI assigned
Jun 24, 2005
Last updated
Oct 11, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Authorized official

Name
Stephen Kimmel
Title
Ceo
Phone
(325) 670-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 000500 TX Primary

Addresses

Primary practice location

1900 Pine St
Abilene, TX 79601-2432

Mailing address

1900 Pine St
Abilene, TX 79601-2432
Phone (325) 670-2000

Other identifiers 2

IdentifierTypeStateIssuer
HH2619OtherTNBLUE CROSS BLUE SHEILD
138644306MedicaidTX

Other names 1

  • HENDRICK SKILLED NURSING FACILITY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030529000055 TX Part A Provider - Skilled Nursing Facility 1658281993 Practice locations: Abilene, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063418937. Details of each certification follow.

Skilled nursing facility certification: CCN 455683

Legal name
HENDRICK MEDICAL CENTER
Doing business as
HENDRICK SKILLED NURSING FACILITY
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Dec 5, 1986
Last certification
Sep 5, 2024
Beds
20
Ownership / control type
Other Nonprofit
Organization structure
CorporationNon-profit
Incorporated
Feb 26, 1923 in TX
Enrollment address
1900 Pine St
Abilene, TX 79601-2432
Nursing home name
HENDRICK SKILLED NURSING FACILITY

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Hendrick Skilled Nursing FacilityCCN 455683 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare
Ownership
Non profit - Other
Certified
Dec 5, 1986
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
2016.5 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Hendrick Medical Center10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Ownership & related parties

All disclosed owners & managing parties 33

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

NameRoleSinceShare
Paul Waldrop Individual Corporate OfficerBoard Member Jan 1, 2016
Richard Flores Individual Corporate DirectorBoard Member Jan 1, 2022
Hendrick Medical Center Organization, Abilene, TX Corporation, Non-profit Operational/Managerial Control Dec 5, 1986
Adp of the SNF Dec 5, 1986
Jeremy Walker Individual Corporate OfficerVice President/Cfo Sep 23, 2013
Operational/Managerial Control Sep 23, 2013
Organization, Lubbock, TX Consulting firm Adp of the SNF Jun 20, 2025
Leigh Black Individual Corporate DirectorBoard Member Jan 1, 2021
Organization, Brentwood, TN Corporation, For-profit Adp of the SNF Jul 2, 2025
Organization, Abilene, TX Financial institution Adp of the SNF Jul 10, 2025
Bradlee Holland Individual Corporate OfficerPresident/Ceo Jan 10, 2019
Larry Smith Individual Corporate DirectorBoard Member Nov 1, 2012
Organization, Austin, TX Medical staffing company Adp of the SNF Jul 4, 2025
Steven Stafford Individual Adp of the SNF Jun 23, 2023
Organization, Maitland, FL LLC, Medical staffing company, For-profit Adp of the SNF Jun 20, 2025
Evan Harris Individual Corporate DirectorBoard Member Jan 1, 2022
Organization, Rockledge, FL LLC, Medical staffing company, Consulting firm, For-profit Adp of the SNF Jul 10, 2025
Organization, Houston, TX Medical staffing company Adp of the SNF Jun 20, 2025
Matthew Higgins Individual Corporate DirectorBoard Member Jan 1, 2022
David Dwayne Grooms Individual Corporate DirectorBoard Member Jan 1, 2024
Lanny Vinson Individual Corporate DirectorBoard Member Nov 1, 2012
Chad D Ezzell Individual Adp of the SNF Jul 1, 2024
Organization, Dallas, TX Corporation Adp of the SNF Jul 10, 2025
Organization, Plano, TX Medical staffing company Adp of the SNF Jun 20, 2025
Richard Waldraff Individual Corporate DirectorBoard Member Jan 1, 2021
Michael Woodard Individual Corporate DirectorBoard Member Jan 1, 2024
Organization, Brentwood, TN Corporation, For-profit Adp of the SNF Jun 20, 2025
Mark Nix Individual Corporate DirectorBoard Member Jan 1, 2019
Cathy Ashby Individual Corporate DirectorBoard Member Nov 1, 2009
Organization, Cincinnati, OH LLC Adp of the SNF Jun 20, 2025
Richard Darden Individual Corporate DirectorBoard Member Jan 1, 2020
Organization, San Diego, CA LLC, For-profit Adp of the SNF Jun 21, 2025
Randy Lloyd Individual Corporate DirectorBoard Member Jan 1, 2017
Organization, Springfield, MO Adp of the SNF Apr 30, 2025
Scott Hibbs Individual Corporate DirectorBoard Member Jan 1, 2024

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Hendrick Medical CenterAbilene, TX, CCN 45T229 Hospital Operational/Managerial Control Jun 1, 1966
Hendrick Medical Center BrownwoodBrownwood, TX, CCN 450587 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 27, 2020
Hendrick Home HealthAbilene, TX, CCN 457761 Home health agency Operational/Managerial Control May 14, 1985
Hendrick Hospice Care, Inc.Abilene, TX, CCN 451539 Hospice Operational/Managerial Control (100%) May 5, 2009

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 4

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

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 4

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": "1119571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1063418937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 PINE ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796012432",
            "telephone_number": "325-670-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 PINE ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796012432",
            "telephone_number": "325-670-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDRICK MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-24",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "KIMMEL",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "325-670-2000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "000500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "HH2619",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138644306",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HENDRICK SKILLED NURSING FACILITY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.