NPIMap

Organization Active NPI

Eagle'S Trace Inc

  • Skilled Nursing Facility
  • Houston, TX
National Provider Identifier
1144580192
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
136818 Issued in TX
Legal business name
EAGLE'S TRACE INC
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
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
James K Walter
Title
Finance Director
Phone
(410) 402-2315

Owners & managing parties with NPI records 1

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

Other NPIs with the same Medicare PAC ID 1

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

Corporate family (same tax ID) 1

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

Facilities with the same owner 87

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

View all 87

Affiliated clinicians 2

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Continuing Care at Eagles TraceCCN 676336
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
May 15, 2013
Medicare certification status
Active (Provider of Services file)
Certified beds
4441.5 residents per day on average
Chain
Erickson Senior Living17 facilities in the chain
Penalties (3 years)
2Fines totaling $22,486

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
45D1048298Ehmg of TX Eagles Trace Medical Center14703 Eagle Vista Drive, Houston, TX 77077Certificate of waiverNov 28, 2027
45D2164923Ehwc Eagles Trace14703 Eagle Vista Drive, Houston, TX 77077Certificate of waiverApr 15, 2027

Medicare participation

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

Skilled nursing facility certification: CCN 676336

Medicare enrollment files
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
CorporationNon-profit
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

All disclosed owners & managing parties 32

Medicare enrollment files

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

NameRoleSinceShare
Russel N Sharp Individual Corporate DirectorBoard Member Apr 1, 2023
Organization, Catonsville, MD LLC Adp of the SNF Feb 12, 2010
Ian Brown Individual Corporate DirectorBoard Member Apr 1, 2023
National Senior Communities, Inc Organization, Catonsville, MD Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 14, 2021 100%
Operational/Managerial Control Jan 14, 2021
William Pomeranz Individual Corporate DirectorBoard Member Apr 1, 2025
Michael Roskiewicz Individual Corporate OfficerVice Chair & Vice President Apr 1, 2025
Corporate DirectorBoard Member Apr 1, 2019
Patricia Brown Individual Corporate DirectorBoard Member Apr 1, 2022
Stephanie L Reel Individual Corporate DirectorBoard Member Apr 1, 2018
Neal a Gantert Individual Corporate OfficerAssistant Treasurer Apr 1, 2024
Operational/Managerial Control Apr 1, 2024
Adp of the SNF Apr 1, 2024
Mary D Colins Individual Corporate OfficerSecretary Apr 1, 2019
Corporate DirectorBoard Member Apr 1, 2018
Daniel Tyler Individual Corporate OfficerAssistant Treasurer Apr 1, 2025
Eileen G Erstad Individual Corporate OfficerTreasurer Apr 1, 2018
Corporate DirectorBoard Member Apr 1, 2018
Mary Moscato Individual Corporate DirectorBoard Member Apr 1, 2024
Monty C Leonard Individual Corporate DirectorBoard Member Apr 1, 2022
Daniel Wallick Individual Corporate DirectorBoard Member Apr 1, 2025
Pamela Paulk Individual Corporate OfficerChair & President Apr 1, 2025
Corporate DirectorBoard Member Apr 1, 2022
Brian N Tremaine Individual Operational/Managerial Control Nov 1, 2011
Adp of the SNF Mar 23, 2025
Organization, Catonsville, MD LLC Adp of the SNF Feb 12, 2010
Oak Investment Trust Organization, Tampa, FL 5% Or Greater Indirect Ownership Interest Jan 1, 2025 23.93%
Adp of the SNF Jan 1, 2025
Karen Buck Individual Operational/Managerial Control Jun 2, 2025
Adp of the SNF Jun 2, 2025
Erickson Senior Living LLC Organization, Catonsville, MD LLC, Management services company, For-profit, Chain home office Operational/Managerial Control Nov 23, 2020 100%
Adp of the SNF Mar 23, 2025
Christian Sweetser Individual Operational/Managerial Control Mar 1, 2022
Adp of the SNF Mar 1, 2022
Oak Investment Trust II Organization, Tampa, FL 5% Or Greater Indirect Ownership Interest Jan 1, 2025 63.74%
Adp of the SNF Jan 1, 2025
Organization, Catonsville, MD LLC Adp of the SNF Feb 12, 2010
John Hall Individual Corporate OfficerAssistant Treasurer Apr 1, 2024
Operational/Managerial Control Apr 1, 2024
Adp of the SNF Apr 1, 2024
Katherine L Clupper Individual Corporate DirectorBoard Member Apr 1, 2024
Zina Jacque Individual Corporate DirectorBoard Member May 15, 2013
Richard a Butler Individual Operational/Managerial Control Jan 1, 2014
Scott R Sawicki Individual Corporate OfficerAssistant Secretary Apr 1, 2024
Mark D Embley Individual Corporate OfficerAssistant Treasurer Apr 1, 2022
Operational/Managerial Control Apr 1, 2022
Adp of the SNF Apr 1, 2022
Pamela Stiner Individual Corporate OfficerAssistant Treasurer Apr 1, 2024
Operational/Managerial Control Apr 1, 2024
Adp of the SNF Apr 1, 2024
Organization, Hanover, MD LLC Adp of the SNF Feb 12, 2010
Indirect Ownership Interest Nov 23, 2020 99%

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20120813000209 TX Part a Provider - Skilled Nursing Facility 2466452164 Practice locations: Houston, TX

National Provider Directory

National Provider Directory
Tax ID family
Continuing Care at Eagle'S Trace (2 organizations share this tax ID)

Locations

14703 Eagle Vista Dr
Bldg 601B
Houston, TX 77077
Phone (281) 249-7000

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 136818 TX Primary

Addresses

NPPES NPI Registry

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

NPPES NPI Registry
  • CONTINUING CARE AT EAGLE'S TRACE Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 16, 2015.

{
    "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

Sources for this page

Verify at the official NPI Registry.