NPIMap

Organization Active NPI

Barton Creek Senior Living Center Inc.

  • Skilled Nursing Facility
  • Austin, TX
National Provider Identifier
1215071428
Registry record updated Dec 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
BARTON CREEK SENIOR LIVING CENTER INC.
Practice address
2500 Barton Creek Blvd
Austin, TX 78735-1616
Phone
(512) 610-9424
Fax
(512) 610-9427
NPI assigned
Feb 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2007

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

Authorized official

Name
Mr. Ross Alan Dickmann
Title
Executive Director
Phone
(512) 610-9424

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X TX
Skilled Nursing Facility 314000000X TX Primary

Addresses

Primary practice location

2500 Barton Creek Blvd
Austin, TX 78735-1616

Mailing address

2500 Barton Creek Blvd
Austin, TX 78735-1616
Phone (512) 610-9424

Other names 1

  • Querencia at Barton Creek Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070702000601 TX Part A Provider - Skilled Nursing Facility 9931209046 Practice locations: Austin, TX

Skilled nursing facility certification: CCN 676198

Legal name
BARTON CREEK SENIOR LIVING CENTER INC.
Doing business as
QUERENCIA AT BARTON CREEK
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Oct 21, 2008
Last certification
Sep 20, 2024
Beds
42
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Life Space Community
Organization structure
CorporationNon-profit
Incorporated
Apr 30, 2003 in TX
Enrollment address
2500 Barton Creek Blvd
Austin, TX 78735-1616
Nursing home name
QUERENCIA AT BARTON CREEK
Affiliated entity
LIFESPACE COMMUNITIES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Querencia at Barton CreekCCN 676198
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare
Ownership
Non profit - Corporation
Certified
Oct 21, 2008
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4238.4 residents per day on average
Chain
Lifespace Communities15 facilities in the chain
Penalties (3 years)
1Fines totaling $13,500

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
45D1068097Barton Creek Senior Living Center Inc2500 Barton Creek Blvd, Austin, TX 78735Certificate of waiverMay 1, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Dana Smith Individual Corporate OfficerSecretary Jul 1, 2022
Corporate Director Jul 1, 2022
Nicholas Harshfield Individual Corporate OfficerChief Financial Officer Jul 1, 2020
Corporate DirectorChief Financial Officer Mar 3, 2021
Lifespace Communities Inc Organization, West Des Moines, IA Non-profit Operational/Managerial Control Jun 27, 2019
Nathan Weyand Individual W-2 Managing Employee Jan 16, 2012
Erin Pope Individual Corporate Officer Jul 25, 2022
Jesse Jantzen Individual Corporate Officer Apr 1, 2020
Corporate DirectorPresident and Ceo Mar 2, 2021
Timothy Stuteville Individual W-2 Managing EmployeeAssoc. Executive Director Aug 5, 2013

Owners & managing parties with NPI records 10

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

Facilities with the same owner 15

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

View all 15

Practitioners & affiliated clinicians

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": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1215071428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 BARTON CREEK BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787351616",
            "telephone_number": "512-610-9424",
            "fax_number": "512-610-9427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 BARTON CREEK BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787351616",
            "telephone_number": "512-610-9424",
            "fax_number": "512-610-9427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARTON CREEK SENIOR LIVING CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "DICKMANN",
        "authorized_official_first_name": "ROSS",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "512-610-9424",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Querencia at Barton Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.