NPIMap

Organization Active NPI

Fort Worth Skilled Care, LLC

  • Skilled Nursing Facility
  • Fort Worth, TX
National Provider Identifier
1306239587
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
FORT WORTH SKILLED CARE, LLC
Practice address
4515 Village Creek Rd
Fort Worth, TX 76119-4158
Phone
(817) 451-8704
Fax
(817) 451-0048
NPI assigned
Mar 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Authorized official

Name
Mr. Brian K Thomas
Title
Manager
Phone
(254) 897-1430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

4515 Village Creek Rd
Fort Worth, TX 76119-4158

Mailing address

1019 Holden St
Glen Rose, TX 76043-4937
Phone (254) 897-1430

Other identifiers 2

IdentifierTypeStateIssuer
001026850MedicaidTX
4529MedicaidTX

Other names 1

  • Immanuels Healthcare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150429000649 TX Part A Provider - Skilled Nursing Facility 1850610650 Practice locations: Fort Worth, TX

Skilled nursing facility certification: CCN 676052

Legal name
FORT WORTH SKILLED CARE LLC
Doing business as
IMMANUEL'S HEALTHCARE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
May 11, 2005
Last certification
May 9, 2024
Beds
84
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Enrollment address
4515 Village Creek Rd
Fort Worth, TX 76119-4158
Nursing home name
IMMANUEL'S HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Immanuel'S HealthcareCCN 676052
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
May 11, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8465.9 residents per day on average

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
45D2157248Fort Worth Skilled Care, LLC4515 Village Creek Rd, Fort Worth, TX 76119Certificate of waiverNov 1, 2026

National Provider Directory

National Provider Directory
Tax ID family
Fort Worth Skilled Care LLC2 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 5

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

NameRoleSinceShare
Brian K Thomas Individual 5% Or Greater Direct Ownership InterestManager Oct 31, 2014 51%
Operational/Managerial Control Oct 31, 2014
Adp of the SNF Oct 31, 2014
Direct Ownership Interest Oct 31, 2014 51%
TGR Healthcare, LLC Organization, Glen Rose, TX LLC, Management services company, For-profit Operational/Managerial Control Apr 30, 2015 100%
Adp of the SNF Apr 17, 2025
Individual Adp of the SNF Dec 9, 2024
Individual Adp of the SNF Apr 17, 2025
Ricardo L Villa Individual 5% Or Greater Direct Ownership InterestManager Oct 31, 2014 49%
Operational/Managerial Control Oct 31, 2014

Facilities with the same owner 5

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

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 1

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": "1426032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771372800000",
    "number": "1306239587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 HOLDEN ST",
            "city": "GLEN ROSE",
            "state": "TX",
            "postal_code": "760434937",
            "telephone_number": "254-897-1430",
            "fax_number": "254-897-1486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 VILLAGE CREEK RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761194158",
            "telephone_number": "817-451-8704",
            "fax_number": "817-451-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WORTH SKILLED CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-11",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "254-897-1430",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001026850",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4529",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Immanuels Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.