NPIMap

Organization Active NPI

Hickory Trail Hospital, L.P.

  • Psychiatric Hospital
  • Desoto, TX
National Provider Identifier
1205999232
Registry record updated Apr 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
008378 Issued in TX
Legal business name
HICKORY TRAIL HOSPITAL, L.P.
Practice address
2000 Old Hickory TRL
Desoto, TX 75115-2242
Phone
(972) 298-7323
Fax
(972) 709-0581
NPI assigned
Dec 19, 2006
Last updated
Apr 27, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2011

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

Authorized official

Name
Steve Filton
Title
SRVP Cfo
Phone
(610) 678-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 008378 TX Primary

Addresses

Primary practice location

2000 Old Hickory TRL
Desoto, TX 75115-2242

Mailing address

2000 Old Hickory TRL
Desoto, TX 75115-2242
Phone (972) 298-7323

Other identifiers 1

IdentifierTypeStateIssuer
184076101MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060912000209 TX Part A Provider - Hospital 5991709677 Practice locations: Desoto, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205999232. Details of each certification follow.

Hospital certification: CCN 454065

Legal name
HICKORY TRAIL HOSPITAL, L.P.
Doing business as
HICKORY TRAIL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Apr 27, 1988
Last certification
May 28, 2013
Beds
76
Ownership / control type
Private (for profit)
Most recent change of ownership
Jul 1, 2006 (5 total)
Organization structure
PartnershipProprietary
Incorporated
May 23, 2006 in DE
Enrollment address
2000 Old Hickory TRL
Desoto, TX 75115-2242
Main/Primary Hospital Location
Hospital subgroups
Psychiatric

Care Compare: Hospital

Medicare Care Compare
Listed as
Hickory Trail HospitalCCN 454065 · All quality measures
Type
Psychiatric
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Hickory Trail Hospital LP2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
George H Brunner Individual Corporate OfficerAssistant Secretary Nov 15, 2010 100%
Psychiatric Solutions Hospitals LLC Organization, King of Prussia, PA LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jul 1, 2006 100%
Tyrel C Culver Individual Contracted Managing EmployeeCfo Feb 3, 2020
Corporate OfficerCfo Feb 3, 2020
Katharine M Lyver Individual Corporate OfficerAssistant Treasurer Jan 1, 2024 100%
Matthew D Klein Individual Corporate OfficerSecretary Nov 15, 2010 100%
Matthew J Peterson Individual Corporate OfficerPresident Sep 19, 2019 100%
Corporate DirectorPresident Sep 19, 2019 33.3%
Operational/Managerial ControlPresident Sep 19, 2019 100%
Thomas M Day Individual Corporate OfficerVice President Jul 20, 2021 100%
Corporate DirectorVice President Jul 20, 2021 33.3%
Steve Filton Individual Corporate OfficerVice President Nov 15, 2010 100%
Corporate DirectorVice President Nov 15, 2010 33.3%
Operational/Managerial ControlVice President Nov 15, 2010 100%
Texas Hospital Holdings LLC Organization, King of Prussia, PA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 1, 2006 1%
General Partnership Interest Jul 1, 2006 1%
Cheryl K Ramagano Individual Corporate OfficerTreasurer Nov 15, 2010 100%
Universal Health Services Inc Organization, King of Prussia, PA Corporation, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Nov 15, 2010 100%
James M Coleman Individual Contracted Managing EmployeeSenior Reimbursement Manager Nov 15, 2010 50%
Texas Hospital Holdings Inc Organization, King of Prussia, PA Corporation, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 1, 2006 99%
Limited Partnership Interest Jul 1, 2006 99%
Uhs of Delaware Inc Organization, King of Prussia, PA Corporation, Management services company, Chain home office Operational/Managerial Control Nov 15, 2010 100%
Psychiatric Solutions, Inc. Organization, King of Prussia, PA Corporation, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Nov 1, 2006 100%
Alan B Miller Individual 5% Or Greater Indirect Ownership InterestChiarman of the Board Mar 18, 2024 87.4%
Jeffrey Dewitt Baker Individual Contracted Managing EmployeeCeo Oct 25, 2021
Corporate OfficerCeo Oct 25, 2021

Facilities with the same owner 172

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

View all 172

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303862400000",
    "number": "1205999232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 OLD HICKORY TRL",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152242",
            "telephone_number": "972-298-7323",
            "fax_number": "972-709-0581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 OLD HICKORY TRL",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152242",
            "telephone_number": "972-298-7323",
            "fax_number": "972-709-0581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HICKORY TRAIL HOSPITAL, L.P.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2011-04-27",
        "status": "A",
        "authorized_official_last_name": "FILTON",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "SRVP CFO",
        "authorized_official_telephone_number": "610-678-3300"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "TX",
            "license": "008378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184076101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

Verify at the official NPI Registry.