Active NPI
Buckingham Senior Living Community Inc
- Skilled Nursing Facility
- Houston, TX
National Provider Identifier
1356396279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 116910
- Legal business name
- BUCKINGHAM SENIOR LIVING COMMUNITY INC
- Practice address
- 8530 Woodway Dr
Houston, TX 77063-2423 - Phone
- (713) 979-3777
- Fax
- (713) 979-3778
- NPI assigned
- May 23, 2006
- 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
- Jean Dopler
- Title
- Billing Specialist
- Phone
- (903) 413-1448
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 116910 | TX | Primary |
Addresses
Primary practice location
8530 Woodway Dr
Houston, TX 77063-2423
Mailing address
8580 Woodway Dr
Houston, TX 77063-2423
Phone (713) 979-3100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102407 | Other | TX | TDADS FACILITY ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060608000123 | TX | Part A Provider - Skilled Nursing Facility | 1951313097 | Practice locations: Houston, TX |
Skilled nursing facility certification: CCN 676111
- Legal name
- BUCKINGHAM SENIOR LIVING COMMUNITY INC
- Doing business as
- THE BUCKINGHAM
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF (Medicare) only
- Participating since
- Aug 28, 2006
- Last certification
- Jul 25, 2024
- Beds
- 92
- Ownership / control type
- Other Nonprofit
- Organization structure
- Corporation
- Incorporated
- Jul 26, 2002 in TX
- Enrollment address
- 8580 Woodway Dr
Houston, TX 77063-2423 - Nursing home name
- FFIII HOUSTON SNF TENANT LLC
Care Compare: Nursing home
Medicare Care Compare- Listed as
- FFIII Houston SNF Tenant LLC
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare
- Ownership
- Non profit - Other
- Certified
- Aug 28, 2006
- Medicare certification status
- Active
- Certified beds
- 92
- Penalties (3 years)
- 1
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Biju Oommen | W-2 Managing Employee | Jul 26, 2002 | |
| Greystone Management Services Company, LLC | Operational/Managerial Control | Jul 26, 2006 | |
| Charles Waterhouse | Corporate Director | Oct 2, 2013 | |
| Charles B Brewer | Corporate Director | Jul 26, 2002 | |
| Philip Jacob | W-2 Managing Employee | Aug 29, 2011 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Geriatric Medicine (Internal Medicine) Physician
- Houston, TX
- NPI 1801856240
W-2 Managing Employee
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Family Medicine) Physician
- Houston, TX
- NPI 1609196955
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1676592000000",
"number": "1356396279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8580 WOODWAY DR",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770632423",
"telephone_number": "713-979-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8530 WOODWAY DR",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770632423",
"telephone_number": "713-979-3777",
"fax_number": "713-979-3778"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BUCKINGHAM SENIOR LIVING COMMUNITY INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-23",
"last_updated": "2023-02-17",
"certification_date": "2023-02-17",
"status": "A",
"authorized_official_last_name": "DOPLER",
"authorized_official_first_name": "JEAN",
"authorized_official_title_or_position": "BILLING SPECIALIST",
"authorized_official_telephone_number": "903-413-1448"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "TX",
"license": "116910",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TDADS FACILITY ID",
"identifier": "102407",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; 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.