NPIMap

Organization Active NPI

Decatur Hospital Authority

Doing business as Mansfield Medical Lodge

  • Skilled Nursing Facility
  • Mansfield, TX
National Provider Identifier
1386047645
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
DECATUR HOSPITAL AUTHORITY
Doing business as
Mansfield Medical Lodge
Practice address
301 N Miller Rd
Mansfield, TX 76063-9144
Phone
(817) 276-4800
NPI assigned
Oct 1, 2014
Last updated
May 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Authorized official

Name
Brian Todd Scroggins
Title
Ceo
Phone
(940) 900-4348

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

301 N Miller Rd
Mansfield, TX 76063-9144

Mailing address

301 N Miller Rd
Mansfield, TX 76063-9144
Phone (817) 276-4800

Other identifiers 1

IdentifierTypeStateIssuer
67-6143OtherTXMEDICARE CCN

Other names 1

  • Mansfield Medical Lodge Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150203000067 TX Part A Provider - Skilled Nursing Facility 8325951346 Practice locations: Mansfield, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386047645. Details of each certification follow.

Skilled nursing facility certification: CCN 676143

Legal name
DECATUR HOSPITAL AUTHORITY
Doing business as
MANSFIELD MEDICAL LODGE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Aug 1, 2007
Last certification
Aug 8, 2024
Beds
118
Ownership / control type
Limited Liability Corporation
Multi-facility organization
CARE TRUST REIT
Organization structure
GovernmentNon-profit
Enrollment address
301 N Miller Rd
Mansfield, TX 76063-9144
Nursing home name
MANSFIELD MEDICAL LODGE
Affiliated entity
PRIORITY MANAGEMENT

Other NPIs with the same Medicare PAC ID 9

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Mansfield Medical LodgeCCN 676143 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Aug 1, 2007
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11894.6 residents per day on average
Chain
Priority Management38 facilities in the chain
Penalties (3 years)
1Fines totaling $6,032

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
45D1067025Mansfield Medical Lodge301 N Miller Road, Mansfield, TX 76063Certificate of waiverApr 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Decatur Hospital Authority14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
PMG Opco - Mansfield LLC Organization, Dallas, TX LLC Operational/Managerial Control Dec 1, 2014
Adp of the SNF Feb 18, 2025
Brian T Scroggins Individual Corporate OfficerCeo Dec 1, 2014
Corporate DirectorCfo Oct 3, 2014
Bridgepointe Finanical Services, LLC Organization, Dallas, TX LLC Adp of the SNF Dec 1, 2014
Priority Management Group, LLC Organization, Dallas, TX LLC Adp of the SNF Dec 1, 2014
Ctr Partnership LP Organization, Dallas, TX 5% Or Greater Mortgage Interest Dec 1, 2014 100%
Adp of the SNF Dec 1, 2014
Jonathan Tyner Individual Operational/Managerial Control Sep 1, 2021
Adp of the SNF Sep 1, 2021
Caretrust Reit Inc Organization, Dallas, TX Real estate investment trust (REIT) 5% Or Greater Mortgage Interest Dec 1, 2014 100%
Adp of the SNF Dec 1, 2014
Individual Adp of the SNF Jan 1, 2025
Innovative Nurse Consulting, LLC Organization, Dallas, TX LLC Adp of the SNF Dec 1, 2014
Progressive Rehab Solutions, LLC Organization, Dallas, TX LLC Adp of the SNF Dec 1, 2014
Decatur Hospital Authority Organization, Decatur, TX 5% Or Greater Direct Ownership Interest Dec 1, 2014 100%

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 8

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

FacilityTypeRoleSince
Cityview Nursing and Rehabilitation CenterFort Worth, TX, CCN 675622 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Aug 31, 2014
Sep 10, 2025
Fort Worth Transitional Care CenterFort Worth, TX, CCN 676255 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Jul 25, 2014
Mar 4, 2026
Ridgmar Medical LodgeFort Worth, TX, CCN 676101 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2014
Grapevine Medical LodgeGrapevine, TX, CCN 676104 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2014
Midwestern Healthcare CenterWichita Falls, TX, CCN 675128 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Pecan Tree Rehab and Healthcare CenterGainesville, TX, CCN 675550 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2025
Bridgeport Medical LodgeBridgeport, TX, CCN 675891 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2025
Decatur Medical LodgeDecatur, TX, CCN 676209 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2025

Owned or controlled facilities with NPI records 8

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

Facilities with the same owner 8

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1412121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747785600000",
    "number": "1386047645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N MILLER RD",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760639144",
            "telephone_number": "817-276-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N MILLER RD",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760639144",
            "telephone_number": "817-276-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-01",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A",
        "authorized_official_last_name": "SCROGGINS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "940-900-4348"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CCN",
            "identifier": "67-6143",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mansfield Medical Lodge",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mansfield Medical Lodge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.