NPIMap

Organization Active NPI

Ballinger Memorial Hospital District

Doing business as Park Plaza Nursing and Rehabilitation Center

  • Skilled Nursing Facility
  • San Angelo, TX
National Provider Identifier
1376306944
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
BALLINGER MEMORIAL HOSPITAL DISTRICT
Doing business as
Park Plaza Nursing and Rehabilitation Center
Practice address
2210 Howard Street
San Angelo, TX 76901-1318
Phone
(325) 944-0561
Fax
(325) 944-0562
NPI assigned
Feb 5, 2024
Last updated
Feb 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Authorized official

Name
Mr. Rhett Fricke
Title
Chief Executive Officer
Phone
(325) 365-2531

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

2210 Howard Street
San Angelo, TX 76901-1318

Mailing address

4150 International Plaza
Suite 200
Fort Worth, TX 76109-4875
Phone (817) 348-8959

Other names 1

  • Park Plaza Nursing and Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240531000281 TX Part A Provider - Skilled Nursing Facility 0042200180 Practice locations: San Angelo, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376306944. Details of each certification follow.

Skilled nursing facility certification: CCN 675982

Legal name
BALLINGER MEMORIAL HOSPITAL DISTRICT
Doing business as
PARK PLAZA NURSING AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Jul 23, 2003
Last certification
Mar 13, 2025
Beds
90
Ownership / control type
Corporation
Multi-facility organization
Creative Solutions Healthcare
Organization structure
OtherProprietary
Enrollment address
2210 Howard Street
San Angelo, TX 76901-1318
Nursing home name
PARK PLAZA NURSING AND REHABILITATION CENTER
Affiliated entity
CREATIVE SOLUTIONS IN HEALTHCARE

Other NPIs with the same Medicare PAC ID 7

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Park Plaza Nursing and Rehabilitation CenterCCN 675982 · All quality measures
Overall star rating
3 of 5
Health inspections
4 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jul 23, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9040.2 residents per day on average
Chain
Creative Solutions in Healthcare149 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Ballinger Memorial Hospital7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Ballinger Memorial Hospital District Organization, Ballinger, TX For-profit 5% Or Greater Direct Ownership Interest Feb 1, 2024 100%
Mike Dankworth Individual Managing Control - Governing BodyPresident Jan 1, 2025
John D Hunt Individual Adp of the SNF Apr 14, 2025
Scott Studer Individual Managing Control - Governing BodyBoard Member Jan 1, 2025
Malisa a Blake Individual Operational/Managerial Control Feb 1, 2024
William Hunter Individual Managing Control - Governing BodyVice President Jan 1, 2025
Bradly Bundrant Individual Managing Control - Governing BodyBoard Member Jan 1, 2025
Elizabeth Zuniga Individual Managing Control - Governing BodySecretary Jan 1, 2025
Gary R Blake Individual Operational/Managerial Control Feb 1, 2024
Adp of the SNF Feb 1, 2024
San Angelo I Enterprises, LLC Organization, Fort Worth, TX LLC, Management services company, For-profit Operational/Managerial Control Feb 1, 2024 100%
Adp of the SNF Apr 14, 2025
Linda F Huggins Individual Corporate DirectorVP of Accounts Receivable Feb 1, 2024
Rhett Fricke Individual Corporate OfficerChief Executive Officer Feb 1, 2024 100%
Managing Control - Governing BodyChief Executive Officer Feb 1, 2024
Mark Atwood Individual Managing Control - Governing BodyBoard Member Jan 1, 2025
Tyler Reasor Individual Managing Control - Governing BodyBoard Member Jan 1, 2025
Rolando Aguilar Individual Adp of the SNF Apr 14, 2025
Zachary Willig Individual Corporate DirectorLicensing Manager Jan 1, 2025

Owners & managing parties with NPI records 9

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

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Ballinger Memorial HospitalBallinger, TX, CCN 451310 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 24, 2008
Ballinger Memorial HospitalBallinger, TX, CCN 45Z310 Hospital 5% Or Greater Direct Ownership Interest Jan 1, 1990
Ballinger Healthcare and Rehabilitation CenterBallinger, TX, CCN 675614 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2022
Cedar Manor Nursing and Rehabilitation CenterSan Angelo, TX, CCN 676068 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2024
Ballinger Hospital ClinicBallinger, TX, CCN 458867 Rural health clinic 5% Or Greater Direct Ownership Interest Nov 1, 2005

Owned or controlled facilities with NPI records 6

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

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, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

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": "1707091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1376306944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 INTERNATIONAL PLAZA",
            "address_2": "SUITE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094875",
            "telephone_number": "817-348-8959",
            "fax_number": "817-348-0466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 HOWARD STREET",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769011318",
            "telephone_number": "325-944-0561",
            "fax_number": "325-944-0562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALLINGER MEMORIAL HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-12",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "FRICKE",
        "authorized_official_first_name": "RHETT",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "325-365-2531",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Plaza Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Park Plaza Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.