NPIMap

Organization Active NPI

City of Ennis

  • Skilled Nursing Facility
  • Granbury, TX
National Provider Identifier
1306440409
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CITY OF ENNIS
Practice address
600 Reunion CT
Granbury, TX 76048-1610
Phone
(817) 573-3773
Fax
(817) 573-0103
NPI assigned
Nov 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Authorized official

Name
Stephen Barnes
Title
Finance Director
Phone
(972) 875-1234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

600 Reunion CT
Granbury, TX 76048-1610

Mailing address

600 Reunion CT
Granbury, TX 76048-1610
Phone (817) 573-3773

Other names 1

  • Trinity Nursing & Rehab of Granbury Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210225003053 TX Part A Provider - Skilled Nursing Facility 6507982717 Practice locations: Granbury, TX

Skilled nursing facility certification: CCN 675084

Legal name
CITY OF ENNIS
Doing business as
TRINITY NURSING & REHAB OF GRANBURY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Oct 2, 1992
Last certification
May 16, 2024
Beds
90
Ownership / control type
Limited Liability Corporation
Multi-facility organization
SENIOR LIVING PROPERTIES
Organization structure
OtherNon-profit
Enrollment address
600 Reunion CT
Granbury, TX 76048-1610

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Avir at GranburyCCN 675084
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Oct 2, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9049.1 residents per day on average
Penalties (3 years)
1Fines totaling $66,367

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
45D1070048City of Ennis Dba Trinity Nursing &600 Reunion Court, Granbury, TX 76048Certificate of waiverJun 19, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Darren Boswell Individual Adp of the SNF Aug 1, 2023
Angela Wade Individual Corporate OfficerCity Secretary Feb 10, 2021
Sondra Sauernheimer Individual Operational/Managerial Control Nov 7, 2022
Adp of the SNF Nov 7, 2022
WM 41 Lake Jackson Re LLC Organization, Bedford, TX LLC, Owned by another organization or individual 5% Or Greater Mortgage Interest Aug 1, 2023 100%
Adp of the SNF Aug 1, 2023
Joshua Leonard Individual Operational/Managerial Control Oct 1, 2024
City of Ennis Organization, Ennis, TX Owned by another organization or individual 5% Or Greater Direct Ownership Interest Feb 10, 2021 100%
Melchor Acosta Individual Operational/Managerial Control Mar 1, 2022
Adp of the SNF Mar 1, 2022
SLP Granbury, LLC` Organization, Bedford, TX LLC Operational/Managerial Control Feb 10, 2021
Adp of the SNF Mar 31, 2025

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Killeen Nursing & RehabilitationKilleen, TX, CCN 676438 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2020
Parkwood in the PinesLufkin, TX, CCN 455673 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 16, 2021

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 3

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": "1606694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606694400000",
    "number": "1306440409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 REUNION CT",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481610",
            "telephone_number": "817-573-3773",
            "fax_number": "817-573-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 REUNION CT",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481610",
            "telephone_number": "817-573-3773",
            "fax_number": "817-573-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF ENNIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "972-875-1234"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Nursing & Rehab of Granbury",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Granbury, TX

Sources for this page

Verify at the official NPI Registry.