NPIMap

Organization Active NPI

Medina County Hospital District

Doing business as Cibolo Creek

  • Skilled Nursing Facility
  • Boerne, TX
National Provider Identifier
1386876753
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MEDINA COUNTY HOSPITAL DISTRICT
Doing business as
Cibolo Creek
Practice address
1440 River Rd
Boerne, TX 78006-9998
Phone
(936) 634-6633
Fax
(936) 634-6613
NPI assigned
Aug 18, 2009
Last updated
Jul 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

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

Authorized official

Name
Melissa Ripps
Title
Financial Analyst
Phone
(830) 426-7947

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1440 River Rd
Boerne, TX 78006-9998

Mailing address

1440 River Rd
Boerne, TX 78006-9998

Other names 1

  • Cibolo Creek Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210707003557 TX Part A Provider - Skilled Nursing Facility 6709932049 Practice locations: Boerne, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386876753. Details of each certification follow.

Skilled nursing facility certification: CCN 676240

Legal name
MEDINA COUNTY HOSPITAL DISTRICT
Doing business as
CIBOLO CREEK
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Dec 2, 2009
Last certification
Aug 2, 2024
Beds
120
Ownership / control type
Hospital District
Organization structure
GovernmentNon-profit
Enrollment address
1440 River Road
Boerne, TX 78006-1958
Nursing home name
CIBOLO CREEK

Other NPIs with the same Medicare PAC ID 10

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Cibolo CreekCCN 676240 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Government - Hospital district
Certified
Dec 2, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12088.5 residents per day on average
Penalties (3 years)
2Fines totaling $13,627

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
45D1105792Cibolo Creek1440 River Rd, Boerne, TX 78006Certificate of waiverSep 28, 2027

National Provider Directory

National Provider Directory
Tax ID family
Medina County Hospital District10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

1440 River Rd
#1958
Boerne, TX 78006

1028 Country Ln
Castroville, TX 78009
Phone (210) 232-6464

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Cascade-Kendall Health Services, LTD Organization, Boerne, TX Management services company, For-profit Operational/Managerial Control May 1, 2021 100%
John Trenton Sorrells Individual Adp of the SNF May 1, 2021
Medina County Hospital District Organization, Hondo, TX Non-profit 5% Or Greater Direct Ownership Interest May 1, 2021 100%
Ronald M Haney Individual Operational/Managerial ControlPrincipal of Contracted MGMT Co May 1, 2021 50%
Adp of the SNF May 1, 2021
Boerne HC LLC Organization, Boerne, TX LLC Adp of the SNF May 1, 2021
Taylor Collier Individual Adp of the SNF Aug 22, 2023
Billie Bell Individual Corporate OfficerCeo Jun 3, 2023

Owners & managing parties with NPI records 11

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
Town and Country Nursing and Rehabilitation CenterBoerne, TX, CCN 455796 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2014
Medina Valley Health & Rehabilitation CenterCastroville, TX, CCN 675974 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2014
Guadalupe Valley Nursing and Rehabilitation CenterSeguin, TX, CCN 455869 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Jun 1, 2014
Jan 15, 2026
Las Colinas of WestoverSan Antonio, TX, CCN 676328 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 31, 2017
Windcrest Nursing and RehabilitationWindcrest, TX, CCN 455533 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2025
Medical Clinic of CastrovilleCastroville, TX, CCN 458872 Rural health clinic 5% Or Greater Direct Ownership Interest Oct 1, 2009
Medical Clinic of HondoHondo, TX, CCN 453981 Rural health clinic 5% Or Greater Direct Ownership Interest Oct 1, 2009
Medical Clinic of DevineDevine, TX, CCN 453982 Rural health clinic 5% Or Greater Direct Ownership Interest Oct 1, 2009

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 15

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.

View all 15

Affiliated clinicians 3

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": "1250553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626393600000",
    "number": "1386876753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 RIVER RD",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780069998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 RIVER RD",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780069998",
            "telephone_number": "936-634-6633",
            "fax_number": "936-634-6613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDINA COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-18",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A",
        "authorized_official_last_name": "RIPPS",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "FINANCIAL ANALYST",
        "authorized_official_telephone_number": "830-426-7947"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cibolo Creek",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cibolo Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boerne, TX

Sources for this page

Verify at the official NPI Registry.