Active NPI
Eagle's Trace Inc
Doing business as Continuing Care at Eagle's Trace
- Skilled Nursing Facility
- Houston, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 136818
- Legal business name
- EAGLE'S TRACE INC
- Doing business as
- Continuing Care at Eagle's Trace
- Practice address
- 14703 Eagle Vista Dr
Attn: Extended Care Administrator
Houston, TX 77077-5394 - Phone
- (281) 249-7099
- Fax
- (410) 204-7237
- NPI assigned
- May 24, 2012
- Last updated
- Jan 16, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- James K Walter
- Title
- Finance Director
- Phone
- (410) 402-2315
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 136818 | TX | Primary |
Addresses
Primary practice location
14703 Eagle Vista Dr
Attn: Extended Care Administrator
Houston, TX 77077-5394
Mailing address
14703 Eagle Vista Dr
Attn: Executive Director
Houston, TX 77077-5394
Phone (281) 249-7000
Other names 1
- CONTINUING CARE AT EAGLE'S TRACE
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120813000209 | TX | Part A Provider - Skilled Nursing Facility | 2466452164 | Practice locations: Houston, TX |
NPI to CCN mapping 2
The Medicare certification numbers (CCNs) connected to NPI 1144580192. Details of each certification follow.
Skilled nursing facility certification: CCN 676336
- Legal name
- EAGLES TRACE INC
- Doing business as
- CONTINUING CARE AT EAGLE'S TRACE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- May 15, 2013
- Last certification
- Aug 15, 2024
- Beds
- 44
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Incorporated
- Dec 19, 2002 in MD
- Enrollment address
- 14703 Eagle Vista Drive BLDG 601B
Attn Extended Care Administrator
Houston, TX 77077-5394 - Nursing home name
- CONTINUING CARE AT EAGLES TRACE
- Affiliated entity
- ERICKSON SENIOR LIVING
Outpatient physical therapy / speech pathology certification: CCN 676658
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- REHABILITATION AGENCY AT EAGLES TRACE
- Certification status
- Active
- Provider type (POS)
- Outpatient physical therapy / speech pathology
- Participating since
- May 14, 2007
- Last certification
- Mar 3, 2015
- Ownership / control type
- VOLUNTARY NON PROFIT OTHER THAN CHURCH
- Facility address
- 14703 Eagle Vista Drive
Houston, TX 77077
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Outpatient Rehabilitation Agency at Eagle's Trace
- Rehabilitation Clinic/Center
- Houston, TX
- NPI 1174601447
2466452164
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Continuing Care at Eagles Trace
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- May 15, 2013
- Medicare certification status
- Active
- Certified beds
- 44
- Chain
- Erickson Senior Living
- Penalties (3 years)
- 2
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D1048298 | Ehmg of TX Eagles Trace Medical Center | Certificate of waiver | Nov 28, 2027 |
| 45D2164923 | Ehwc Eagles Trace | Certificate of waiver | Apr 15, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Continuing Care at Eagle's Trace
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Outpatient Rehabilitation Agency at Eagle's Trace
- Rehabilitation Clinic/Center
- Houston, TX
- NPI 1174601447
Locations
14703 Eagle Vista Dr
Bldg 601B
Houston, TX 77077
Phone (281) 249-7000
Ownership & related parties
All disclosed owners & managing parties 32
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Russel N Sharp | Corporate Director | Apr 1, 2023 | |
| Adp of the SNF | Feb 12, 2010 | ||
| Ian Brown | Corporate Director | Apr 1, 2023 | |
| National Senior Communities, Inc | 5% Or Greater Direct Ownership Interest | Jan 14, 2021 | 100% |
| Operational/Managerial Control | Jan 14, 2021 | ||
| William Pomeranz | Corporate Director | Apr 1, 2025 | |
| Michael Roskiewicz | Corporate Officer | Apr 1, 2025 | |
| Corporate Director | Apr 1, 2019 | ||
| Patricia Brown | Corporate Director | Apr 1, 2022 | |
| Stephanie L Reel | Corporate Director | Apr 1, 2018 | |
| Neal a Gantert | Corporate Officer | Apr 1, 2024 | |
| Operational/Managerial Control | Apr 1, 2024 | ||
| Adp of the SNF | Apr 1, 2024 | ||
| Mary D Colins | Corporate Officer | Apr 1, 2019 | |
| Corporate Director | Apr 1, 2018 | ||
| Daniel Tyler | Corporate Officer | Apr 1, 2025 | |
| Eileen G Erstad | Corporate Officer | Apr 1, 2018 | |
| Corporate Director | Apr 1, 2018 | ||
| Mary Moscato | Corporate Director | Apr 1, 2024 | |
| Monty C Leonard | Corporate Director | Apr 1, 2022 | |
| Daniel Wallick | Corporate Director | Apr 1, 2025 | |
| Pamela Paulk | Corporate Officer | Apr 1, 2025 | |
| Corporate Director | Apr 1, 2022 | ||
| Brian N Tremaine | Operational/Managerial Control | Nov 1, 2011 | |
| Adp of the SNF | Mar 23, 2025 | ||
| Adp of the SNF | Feb 12, 2010 | ||
| Oak Investment Trust | 5% Or Greater Indirect Ownership Interest | Jan 1, 2025 | 23.93% |
| Adp of the SNF | Jan 1, 2025 | ||
| Karen Buck | Operational/Managerial Control | Jun 2, 2025 | |
| Adp of the SNF | Jun 2, 2025 | ||
| Erickson Senior Living LLC | Operational/Managerial Control | Nov 23, 2020 | 100% |
| Adp of the SNF | Mar 23, 2025 | ||
| Christian Sweetser | Operational/Managerial Control | Mar 1, 2022 | |
| Adp of the SNF | Mar 1, 2022 | ||
| Oak Investment Trust II | 5% Or Greater Indirect Ownership Interest | Jan 1, 2025 | 63.74% |
| Adp of the SNF | Jan 1, 2025 | ||
| Adp of the SNF | Feb 12, 2010 | ||
| John Hall | Corporate Officer | Apr 1, 2024 | |
| Operational/Managerial Control | Apr 1, 2024 | ||
| Adp of the SNF | Apr 1, 2024 | ||
| Katherine L Clupper | Corporate Director | Apr 1, 2024 | |
| Zina Jacque | Corporate Director | May 15, 2013 | |
| Richard a Butler | Operational/Managerial Control | Jan 1, 2014 | |
| Scott R Sawicki | Corporate Officer | Apr 1, 2024 | |
| Mark D Embley | Corporate Officer | Apr 1, 2022 | |
| Operational/Managerial Control | Apr 1, 2022 | ||
| Adp of the SNF | Apr 1, 2022 | ||
| Pamela Stiner | Corporate Officer | Apr 1, 2024 | |
| Operational/Managerial Control | Apr 1, 2024 | ||
| Adp of the SNF | Apr 1, 2024 | ||
| Adp of the SNF | Feb 12, 2010 | ||
| Indirect Ownership Interest | Nov 23, 2020 | 99% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Geriatric Medicine (Internal Medicine) Physician
- Houston, TX
- NPI 1205897147
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 87
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Continuing Care at Highland Springs
- Skilled Nursing Facility
- Dallas, TX
- NPI 1558620633
Erickson Senior Living LLC, National Senior Communities, Inc, Oak Investment Trust, Oak Investment Trust II
-
dba Ann's Choice
- Skilled Nursing Facility
- Warminster, PA
- NPI 1114096773
Erickson Senior Living LLC, National Senior Communities, Inc
-
dba Ann's Choice Visiting Nurse Service
- Home Health Agency
- Warminster, PA
- NPI 1952489254
Erickson Senior Living LLC, National Senior Communities, Inc
-
- Skilled Nursing Facility
- Naples, FL
- NPI 1326771015
Oak Investment Trust, Oak Investment Trust II
-
dba Continuing Care at Ashby Ponds
- Skilled Nursing Facility
- Ashburn, VA
- NPI 1871831222
Erickson Senior Living LLC, National Senior Communities, Inc, Oak Investment Trust, Oak Investment Trust II
-
dba Brooksby Visiting Nurse Service
- Home Health Agency
- Peabody, MA
- NPI 1679696835
Erickson Senior Living LLC, National Senior Communities, Inc
-
dba Continuing Care at Brooksby Village
- Skilled Nursing Facility
- Peabody, MA
- NPI 1780663336
Erickson Senior Living LLC, National Senior Communities, Inc
-
dba Casa de las Campanas
- Skilled Nursing Facility
- San Diego, CA
- NPI 1770566978
Oak Investment Trust, Oak Investment Trust II
-
dba Continuing Care at Cedar Crest Village
- Skilled Nursing Facility
- Pompton Plains, NJ
- NPI 1427015882
Erickson Senior Living LLC, National Senior Communities, Inc
-
dba Cedar Crest Village, Inc., Home Health Department
- Home Health Agency
- Pompton Plains, NJ
- NPI 1790855567
Erickson Senior Living LLC, National Senior Communities, Inc
-
dba Charlestown Care Center
- Skilled Nursing Facility
- Catonsville, MD
- NPI 1932166360
Erickson Senior Living LLC
-
dba Charlestown Home Health Agency
- Home Health Agency
- Catonsville, MD
- NPI 1992704068
Erickson Senior Living LLC
Practitioners & affiliated clinicians
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Internal Medicine) Physician
- Houston, TX
- NPI 1205897147
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337817600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1421366400000",
"number": "1144580192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14703 EAGLE VISTA DR",
"address_2": "ATTN: EXECUTIVE DIRECTOR",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770775394",
"telephone_number": "281-249-7000",
"fax_number": "410-204-7237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14703 EAGLE VISTA DR",
"address_2": "ATTN: EXTENDED CARE ADMINISTRATOR",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770775394",
"telephone_number": "281-249-7099",
"fax_number": "410-204-7237"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EAGLE'S TRACE INC",
"organizational_subpart": "NO",
"enumeration_date": "2012-05-24",
"last_updated": "2015-01-16",
"status": "A",
"authorized_official_last_name": "WALTER",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "FINANCE DIRECTOR",
"authorized_official_telephone_number": "410-402-2315"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "TX",
"license": "136818",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "CONTINUING CARE AT EAGLE'S TRACE",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Houston, TX
- Eagle E Personal Assistance Service L.L.C.
- Eagle EMS LLC (Eagle EMS)
- Eagle Eye Center Bellaire LLC
- Eagle-I Behavioral Health Services PLLC
- Eagle's Trace Home Care, LLC (Eagle's Trace Home Care)
- Eagle's Trace Inc (Outpatient Rehabilitation Agency at Eagle's Trace)
- Eagles Nest Palliative Hospice LLC
- Paola Eagles, DDS
- Eaglesys Health Care Services, Inc
- Briana Alexus Eagleton, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.