NPIMap

Organization Active NPI

Baylor Regional Medical Center at Grapevine

Doing business as Baylor Scott & White Medical Center - Grapevine

  • General Acute Care Hospital
  • Grapevine, TX
National Provider Identifier
1073511762
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
000513 Issued in TX
Legal business name
BAYLOR REGIONAL MEDICAL CENTER AT GRAPEVINE
Doing business as
Baylor Scott & White Medical Center - Grapevine
Practice address
1650 W College St
Grapevine, TX 76051-3565
Phone
(817) 481-1588
Fax
(817) 329-2667
NPI assigned
Jul 7, 2005
Last updated
Apr 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Authorized official

Name
Naman Majahan
Title
Ceo
Phone
(832) 962-0487

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 000513 TX Primary

Addresses

Primary practice location

1650 W College St
Grapevine, TX 76051-3565

Mailing address

PO Box 847229
Dallas, TX 75284-7229
Phone (214) 820-3151

Other names 1

  • Baylor Scott & White Medical Center - Grapevine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20021022000016 TX Part A Provider - Hospital 2668380221 Practice locations: Grapevine, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073511762. Details of each certification follow.

Hospital certification: CCN 450563

Legal name
BAYLOR REGIONAL MEDICAL CENTER AT GRAPEVINE
Doing business as
BAYLOR SCOTT & WHITE MEDICAL CENTER - GRAPEVINE
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Dec 28, 1970
Last certification
Feb 19, 2011
Beds
273
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Aug 21, 1981 in TX
Enrollment address
1650 W College St
Grapevine, TX 76051-3565
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
Baylor Scott & White Medical Center GrapevineCCN 450563 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
BMC at Grapevine Co FN4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1631 Lancaster Dr
Grapevine, TX 76051
Phone (214) 232-5123

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Justin Meier Individual Operational/Managerial ControlSVP Corporate Finance Feb 9, 2023
Pamela Linton Individual Corporate DirectorTrustee Jul 1, 2024
Baylor Health Care System Organization, Dallas, TX Non-profit Operational/Managerial Control Sep 1, 1981
Baylor Scott & White Health Organization, Temple, TX Non-profit Operational/Managerial Control Mar 1, 2014
Olga Young Individual W-2 Managing EmployeeCfo Feb 6, 2019
Operational/Managerial ControlCfo Feb 6, 2019
Rodrick Robinson Individual Corporate DirectorTrustee Oct 1, 2020
Marissa Yarid Hernandez Individual Corporate DirectorTrustee Mar 26, 2021
Timothy L Owens Individual Corporate DirectorTrustee Jul 1, 2024
Jeff Schmeltekopf Individual Corporate DirectorTrustee Jul 1, 2016
Amy J Wilson Individual Operational/Managerial ControlTrustee Mar 31, 2023
Harry Dugger Individual Corporate DirectorTrustee Jul 1, 2019
Naman Mahajan Individual Corporate DirectorCeo Jul 18, 2022
W-2 Managing EmployeeCeo Jul 18, 2022
Operational/Managerial ControlCeo Jul 18, 2022
Baylor Scott & White Holdings Organization, Dallas, TX Non-profit Other Mar 1, 2014
Lisa Hultz Individual Corporate DirectorTrustee Jul 1, 2022

Owners & managing parties with NPI records 1

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

Facilities with the same owner 44

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

View all 44

Practitioners & affiliated clinicians

Practitioners 38

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.

View all 38

Affiliated clinicians 643

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

View all 643

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681257600000",
    "number": "1073511762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847229",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847229",
            "telephone_number": "214-820-3151",
            "fax_number": "214-818-5744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 W COLLEGE ST",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513565",
            "telephone_number": "817-481-1588",
            "fax_number": "817-329-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYLOR REGIONAL MEDICAL CENTER AT GRAPEVINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A",
        "authorized_official_last_name": "MAJAHAN",
        "authorized_official_first_name": "NAMAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "832-962-0487"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TX",
            "license": "000513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baylor Scott & White Medical Center - Grapevine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Baylor Scott & White Medical Center - Grapevine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grapevine, TX

Sources for this page

Verify at the official NPI Registry.