NPIMap

Organization Active NPI

Midland County Hospital District

  • Skilled Nursing Facility
  • Odessa, TX
National Provider Identifier
1104269448
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MIDLAND COUNTY HOSPITAL DISTRICT
Practice address
5001 Office Park
Odessa, TX 79762
Phone
(432) 362-1800
Fax
(432) 362-5300
NPI assigned
Apr 16, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Authorized official

Name
Stephen Bowerman
Title
President/Coo
Phone
(432) 221-4877

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

5001 Office Park
Odessa, TX 79762

Mailing address

5001 Office Park
Odessa, TX 79762-4843
Phone (432) 362-1800

Other names 1

  • Madison Medical Resort Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250115001275 TX Part A Provider - Skilled Nursing Facility 6901709013 Practice locations: Odessa, TX

Skilled nursing facility certification: CCN 676348

Legal name
MIDLAND COUNTY HOSPITAL DISTRICT
Doing business as
MADISON MEDICAL RESORT
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Dec 9, 2013
Last certification
Jan 30, 2025
Beds
124
Ownership / control type
Corporation
Most recent change of ownership
Nov 1, 2024
Organization structure
GovernmentProprietary
Enrollment address
5001 Office Park
Odessa, TX 79762-4843
Nursing home name
MADISON MEDICAL RESORT
Affiliated entity
FOURSQUARE HEALTHCARE

Other NPIs with the same Medicare PAC ID 8

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Madison Medical ResortCCN 676348
Overall star rating
2 of 5
Health inspections
3 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Dec 9, 2013
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
124110.3 residents per day on average
Chain
Foursquare Healthcare10 facilities in the chain
Penalties (3 years)
1Fines totaling $32,445

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2064352Madison Medical Resort5001 Office Park Drive, Odessa, TX 79762Certificate of waiverAug 18, 2027

National Provider Directory

National Provider Directory
Tax ID family
Memorial Hosp Med Ctr9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Ownership & related parties

All disclosed owners & managing parties 28

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

NameRoleSinceShare
John E Miller Individual 5% Or Greater Mortgage InterestTrustee Nov 1, 2024
Operational/Managerial Control Nov 1, 2024
William Campbell Individual 5% Or Greater Mortgage InterestTrustee Nov 1, 2024
David W Miller GS Trust Organization, Rockwall, TX Operational/Managerial Control Nov 17, 2024
SDL GS 5X5 Trust Organization, Rockwall, TX 5% Or Greater Mortgage Interest Nov 1, 2024 32%
Adp of the SNF Jan 15, 2025
Paul M Slaughter Individual Adp of the SNF Jan 15, 2025
Kingsbury Capital LLC Series F Organization, Rockwall, TX LLC Operational/Managerial Control Nov 17, 2024
MNH-Inv Series LLC Series D Organization, Rockwall, TX LLC Operational/Managerial Control Nov 17, 2024
Jem 5X5 Trust Organization, Rockwall, TX 5% Or Greater Mortgage Interest Nov 1, 2024 50%
Adp of the SNF Jan 15, 2025
Campbell GS-Trust Organization, Rockwall, TX 5% Or Greater Mortgage Interest Nov 1, 2024 29.67%
Adp of the SNF Jan 15, 2025
Don Edward Miller Individual 5% Or Greater Mortgage InterestTrustee Nov 1, 2024
Richard Miller Individual Operational/Managerial Control Nov 1, 2024
Stephen Bowerman Individual Corporate OfficerPresident & Coo Nov 1, 2024
Montague NH, LP Organization, Rockwall, TX Owned by another organization or individual 5% Or Greater Mortgage Interest Nov 1, 2024 26.67%
Adp of the SNF Jan 15, 2025
Shane Delbert Lewis Individual Operational/Managerial Control Nov 1, 2024
William Travis Green Individual Adp of the SNF Nov 1, 2024
Lion Plaza LP Organization, Rockwall, TX Operational/Managerial Control Nov 17, 2024
Uptown FS LLC Organization, Rockwall, TX LLC Operational/Managerial Control Nov 17, 2024
Adp of the SNF Jan 15, 2025
John Campbell Individual Operational/Managerial Control Nov 1, 2024
Fairbrook Partners, LP Organization, Rockwall, TX Owned by another organization or individual 5% Or Greater Mortgage Interest Nov 1, 2024 8%
Adp of the SNF Jan 15, 2025
Midland County Hospital District Organization, Midla'ND, TX 5% Or Greater Direct Ownership Interest Nov 1, 2024 100%
John E Miller GS Trust Organization, Rockwall, TX Operational/Managerial Control Nov 17, 2024
Kenneth Campbell Individual Operational/Managerial Control Nov 1, 2024
Miller GS- Trust Organization, Rockwall, TX Owned by another organization or individual 5% Or Greater Mortgage Interest Nov 1, 2024 99%
Adp of the SNF Jan 15, 2025
Richard M Miller GS Trust Organization, Rockwall, TX Operational/Managerial Control Nov 17, 2024
Jec GS Trust Organization, Rockwall, TX Operational/Managerial Control Nov 17, 2024
David W Miller Individual Operational/Managerial Control Nov 1, 2024
Odessa NH Realty, LTD Organization, Rockwall, TX Owned by another organization or individual 5% Or Greater Mortgage Interest Nov 1, 2024 100%
Adp of the SNF Jan 15, 2025
KJC GS Trust Organization, Rockwall, TX Operational/Managerial Control Nov 17, 2024

Owners & managing parties with NPI records 9

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

All facility ownership & control disclosures 8

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

FacilityTypeRoleSince
Encompass Health Rehabilitation Hospital of Midland OdessaMidland, TX, CCN 453057 Hospital 5% Or Greater Indirect Ownership Interest (18%) Jul 1, 2021
Midland Memorial HospitalMidland, TX, CCN 450133 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2015
Avir at MonahansMonahans, TX, CCN 675522 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Focused Care at OdessaOdessa, TX, CCN 675751 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Direct Ownership Interest (100%)		 Apr 1, 2017
Nov 1, 2017
Apr 1, 2017
Focused Care at Hogan ParkMidland, TX, CCN 675910 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 1, 2017
Apr 1, 2017
Focused Care at MidlandMidland, TX, CCN 675985 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 1, 2017
Apr 1, 2017
Focused Care at Fort StocktonFort Stockton, TX, CCN 675722 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Direct Ownership Interest (100%)		 Apr 1, 2017
Apr 1, 2017
Apr 1, 2017
Ashton Medical LodgeMidland, TX, CCN 676430 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2023

Owned or controlled facilities with NPI records 8

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

Facilities with the same owner 17

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

View all 17

Practitioners & affiliated clinicians

Practitioners 3

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

Affiliated clinicians 3

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": "1366070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1104269448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 OFFICE PARK",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797624843",
            "telephone_number": "432-362-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 OFFICE PARK",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "79762",
            "telephone_number": "432-362-1800",
            "fax_number": "432-362-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLAND COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-16",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A",
        "authorized_official_last_name": "BOWERMAN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "PRESIDENT/COO",
        "authorized_official_telephone_number": "432-221-4877"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madison Medical Resort",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.