NPIMap

Organization Active NPI

Baylor Medical Center at Irving

Doing business as Baylor Scott & White Medical Center - Irving

  • Rehabilitation Hospital Unit
  • Irving, TX
National Provider Identifier
1104822915
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
00300 Issued in TX
Legal business name
BAYLOR MEDICAL CENTER AT IRVING
Doing business as
Baylor Scott & White Medical Center - Irving
Practice address
1901 N Macarthur Blvd
Irving, TX 75061-2220
Phone
(972) 579-8104
Fax
(972) 579-5290
NPI assigned
Jun 27, 2005
Last updated
Jun 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Authorized official

Name
Cindy Schamp
Title
Ceo
Phone
(972) 579-8102

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 00300 TX Primary
Substance Use Disorder Rehabilitation Hospital Unit 276400000X 00300 TX

Addresses

Primary practice location

1901 N Macarthur Blvd
Irving, TX 75061-2220

Mailing address

PO Box 841590
Dallas, TX 75284-1590
Phone (214) 820-6710

Other names 1

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071130000659 TX Part A Provider - Hospital 9436067097 Practice locations: Irving, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104822915. Details of each certification follow.

Hospital certification: CCN 45T079

Legal name
BAYLOR MEDICAL CENTER AT IRVING
Doing business as
BAYLOR SCOTT & WHITE MEDICAL CENTER - IRVING
Organization structure
CorporationNon-profit
Incorporated
Feb 24, 1995 in TX
Enrollment address
1901 N Macarthur Blvd
Irving, TX 75061-2220
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Baylor Scott & White Institute for RehabilitationCCN 45T079 · All quality measures
Ownership
Non-profit
Certified
Jul 1, 2016

National Provider Directory

National Provider Directory
Tax ID family
Baylor Med Ctr at Irvin4 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.

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 Scott & White Health Organization, Temple, TX Non-profit Operational/Managerial Control Mar 1, 2014
Stephen Roussel Individual W-2 Managing EmployeeCfo Jun 1, 2016
Operational/Managerial ControlCfo Jun 1, 2016
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
Wendy Hawkins Hermes Individual Operational/Managerial ControlTrustee Jul 1, 2023
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
Cindy Schamp Individual W-2 Managing EmployeePresident Jul 7, 2008
Operational/Managerial ControlPresident Jul 1, 2016
Baylor Scott & White Holdings Organization, Dallas, TX Corporation 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.

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Baylor Scott & White Surgical Hospital - Las ColinasIrving, TX, CCN 450874 Hospital 5% Or Greater Direct Ownership Interest (33.71%) Jun 16, 2003

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 36

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

View all 36

Practitioners & affiliated clinicians

Practitioners 1

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 5

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": "1119830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592352000000",
    "number": "1104822915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841590",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752841590",
            "telephone_number": "214-820-6710",
            "fax_number": "214-820-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 N MACARTHUR BLVD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750612220",
            "telephone_number": "972-579-8104",
            "fax_number": "972-579-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYLOR MEDICAL CENTER AT IRVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-27",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A",
        "authorized_official_last_name": "SCHAMP",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "972-579-8102"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "TX",
            "license": "00300",
            "primary": true
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "TX",
            "license": "00300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baylor Scott & White Medical Center - Irving",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Baylor Scott & White Medical Center - Irving",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.