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Organization Active NPI

Burleson St. Joseph Health Center of Caldwell, Texas

  • Medicare Defined Swing Bed Hospital Unit
  • Caldwell, TX
National Provider Identifier
1144396193
Registry record updated Jun 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
BURLESON ST. JOSEPH HEALTH CENTER OF CALDWELL, TEXAS
Practice address
1101 Woodson Dr
Caldwell, TX 77836-1052
Phone
(979) 567-3245
NPI assigned
Nov 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2014

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

Authorized official

Name
Kathy Kovar
Title
Team Leader PFS
Phone
(979) 567-3245

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

Primary practice location

1101 Woodson Dr
Caldwell, TX 77836-1052

Mailing address

1101 Woodson Dr
Caldwell, TX 77836-1052
Phone (979) 567-3245

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101027000119 TX Part A Provider - Critical Access Hospital 4183723554 Practice locations: Caldwell, TX

Hospital certification: CCN 45Z305

Legal name
BURLESON ST JOSEPH HEALTH CENTER OF CALDWELL TEXAS
Doing business as
CHI ST JOSEPH HEALTH BURLESON HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Sep 25, 1995 in TX
Enrollment address
1101 Woodson Dr
Caldwell, TX 77836-1052
Other Hospital Practice Location

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).

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 30

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

NameRoleSinceShare
Marcia Ory Individual Corporate DirectorMember, Board of Director Jul 1, 2018
Doug Lawson Individual Corporate OfficerEx-Officio Jun 30, 2020
Sylvania Franciscan Health Organization, Toledo, OH Non-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2014
Paul S Goen Individual Corporate DirectorChair of Medical Staff Jul 19, 2021
Michael Steines Individual Corporate DirectorMember, Board of Directors Feb 1, 2010
Gary Whitlock Individual Corporate DirectorMember, Board of Directors Jun 30, 2020
Commonspirit Health Organization, Englewood, CO Non-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2014 100%
Caroline McDonald Individual Corporate DirectorMember, Board of Directors Feb 1, 2010
Robert Upchurch Individual Corporate DirectorSecretary, Board of Directors Feb 1, 2012
Frank Ashley Individual Corporate DirectorMember, Board of Directors Oct 1, 2019
Laura Survant Individual W-2 Managing EmployeeExecutive Director Finance Jan 1, 2008
Brooks Bass Individual Corporate DirectorMember, Board of Directors Jun 30, 2020
Brad Beers Individual Corporate DirectorMember, Board of Directors Jun 30, 2020
Burleson St Joseph Health Center of Caldwell Texas Organization, Bryan, TX Operational/Managerial Control Aug 1, 2010
Nancy Ann Surma Individual Corporate DirectorMember, Board of Directors Jun 30, 2020
St Joseph Services Corp Organization, Bryan, TX Non-profit 5% Or Greater Direct Ownership Interest Nov 1, 2014 100%
Antonio Arreola-Risa Individual Corporate DirectorMember, Board of Directors Feb 1, 2014
Ricardo Diaz Individual Corporate OfficerChief Operating Officer Jan 18, 2016
James Brad White Individual Corporate DirectorMember, Board of Directors Jun 30, 2020
Jane Ainsworth Individual Corporate DirectorMember, Board of Directors Jun 30, 2020
Charles a Ellison Individual Corporate DirectorMember, Board of Directors Feb 1, 2014
James E. Blair Individual Corporate DirectorChairman of the Board Feb 1, 2010
Gina L Flores Individual Corporate DirectorMember, Board of Directors Jun 30, 2020
Theron Park Individual Corporate DirectorEx-Officio Jul 30, 2018
John Smith Individual Corporate DirectorMembers, Board of Directors Jul 1, 2018
Indira S Anupindi Individual Corporate DirectorMember, Board of Directors Jun 30, 2020
Karen M Boone Individual Corporate DirectorMember, Board of Directors Jul 16, 2018
Demetress L Harrell Individual Corporate Director Jun 30, 2020
Bryan Cole, PHD. Individual Corporate DirectorMember, Board of Directors Jul 1, 2017
Mark C Scarmardo Individual Corporate DirectorMember, Board of Directors Feb 1, 2014

Owners & managing parties with NPI records 4

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

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 2

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

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": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401667200000",
    "number": "1144396193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 WOODSON DR",
            "city": "CALDWELL",
            "state": "TX",
            "postal_code": "778361052",
            "telephone_number": "979-567-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 WOODSON DR",
            "city": "CALDWELL",
            "state": "TX",
            "postal_code": "778361052",
            "telephone_number": "979-567-3245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURLESON ST. JOSEPH HEALTH CENTER OF CALDWELL, TEXAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2014-06-02",
        "status": "A",
        "authorized_official_last_name": "KOVAR",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "TEAM LEADER PFS",
        "authorized_official_telephone_number": "979-567-3245"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, TX

Sources for this page

Verify at the official NPI Registry.