Active NPI
Army Retirement Residence Foundation San Antonio
- Skilled Nursing Facility
- San Antonio, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 0163
- Legal business name
- ARMY RETIREMENT RESIDENCE FOUNDATION SAN ANTONIO
- Practice address
- 7400 Crestway Dr
San Antonio, TX 78239-3098 - Phone
- (210) 646-5200
- Fax
- (210) 646-5395
- NPI assigned
- Apr 20, 2006
- Last updated
- Apr 29, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Bruce W Chittenden
- Title
- Cfo
- Phone
- (210) 646-5328
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0163 | TX | Primary |
Addresses
Primary practice location
7400 Crestway Dr
San Antonio, TX 78239-3098
Mailing address
7400 Crestway Dr
San Antonio, TX 78239-3098
Phone (210) 646-5200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100505000067 | TX | Part A Provider - Skilled Nursing Facility | 6507994068 | Practice locations: San Antonio, TX |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1306801220. Details of each certification follow.
Skilled nursing facility certification: CCN 675697
- Legal name
- ARMY RETIREMENT RESIDENCE FOUNDATION SAN ANTONIO
- Doing business as
- ARMY RESIDENCE COMMUNITY
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF (Medicare) only
- Participating since
- Jun 18, 1997
- Last certification
- Apr 26, 2024
- Beds
- 91
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Other
- Enrollment address
- 7400 Crestway Dr
San Antonio, TX 78239-3104 - Nursing home name
- ARMY RESIDENCE COMMUNITY
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Army Residence Community
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare
- Ownership
- Non profit - Corporation
- Certified
- Jun 18, 1997
- Medicare certification status
- Active
- Certified beds
- 91
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D0502036 | Army Residence Community HLTH Care Ctr | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Larry Luken | Corporate Director | Jun 1, 2017 | |
| Tom McGuire | Corporate Director | Jun 1, 2017 | |
| Herb Coley | Corporate Director | Jun 1, 2015 | |
| Barbara Schneider | Corporate Director | Jun 1, 2017 | |
| Roy Johnson | Corporate Officer | Jun 1, 2014 | |
| Maryanne Keogh | Corporate Director | Apr 1, 2010 | |
| W-2 Managing Employee | Apr 1, 2010 | ||
| James Solomon | Corporate Director | Apr 1, 2010 | |
| Kevin Bergner | Corporate Director | Jun 1, 2017 | |
| Rita Gamez | Other | Aug 15, 1997 | |
| Cem Maxwell | Corporate Director | Jun 1, 2014 | |
| Army Retirement Residence Foundation San Antonio | Operational/Managerial Control | Apr 1, 2010 | |
| Jessie Brewer | Corporate Director | Jun 1, 2014 | |
| David Fulbright | Corporate Officer | Sep 25, 2017 | |
| David Dentino | Corporate Director | Jun 1, 2017 | |
| David K. Hayes | Corporate Director | Jun 1, 2015 | |
| Gordon Shoger | Corporate Officer | May 1, 2017 | |
| Donald Mills | Corporate Director | Jun 1, 2017 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Otolaryngology Physician
- Fort Sam Houston, TX
- NPI 1669443883
Corporate Director
Practitioners & affiliated clinicians
Affiliated clinicians 8
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- San Antonio, TX
- NPI 1356471353
Nursing home
-
- Internal Medicine Physician
- Fort Sam Houston, TX
- NPI 1154597706
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145491200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1272499200000",
"number": "1306801220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7400 CRESTWAY DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782393098",
"telephone_number": "210-646-5200",
"fax_number": "210-646-5395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7400 CRESTWAY DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782393098",
"telephone_number": "210-646-5200",
"fax_number": "210-646-5395"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ARMY RETIREMENT RESIDENCE FOUNDATION SAN ANTONIO",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-20",
"last_updated": "2010-04-29",
"status": "A",
"authorized_official_last_name": "CHITTENDEN",
"authorized_official_first_name": "BRUCE",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "210-646-5328",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "TX",
"license": "0163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.