Medina County Hospital District
Organization Active NPI Skilled Nursing Facility · Boerne, TX
NPI 1386876753 · NPPES record last updated Jul 16, 2021
Key facts
- NPI
- 1386876753
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- MEDINA COUNTY HOSPITAL DISTRICT
- Practice address
- 1440 River Rd
Boerne, TX 78006-9998 - Phone
- (936) 634-6633
- Fax
- (936) 634-6613
- NPI assigned
- Aug 18, 2009
- Organization subpart
- No
Authorized official
- Name
- Melissa Ripps
- Title
- Financial Analyst
- Phone
- (830) 426-7947
Owners & managing parties with NPI records 11
-
John T. Sorrells, MD
Owned or controlled facilities with NPI records 8
Other NPIs with the same Medicare PAC ID 10
Corporate family (same tax ID) 9
Facilities with the same owner 8
Practitioners 15
-
Mark A Erspamer, CRNA
-
Dawn George-Mayo, M.D.
-
Jorge Munoz, M.D.
-
Robert B Scholes, CRNA
-
Moises Mateo Soulas Jr., M.D.
-
Troy Frederick Conner, CRNA
-
Yasmeen Tahira Agha, M.D.
-
Antonio A Flores, M.D.
-
Laura Worth Hansen, D.O.
-
Benjamin Joseph McCollum, M.D.
-
Richard Spencer Rowland, M.D.
-
John T. Sorrells, MD
-
Matthew John Windrow, M.D.
Affiliated clinicians 3
-
Yasmeen Tahira Agha, M.D.
-
John T. Sorrells, MD
Medicare Care Compare: Nursing home
- Listed as
- Cibolo Creek
- 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
- Active
- Certified beds
- 120 · 88.5 residents per day on average
- Penalties (3 years)
- 2 · fines totaling $13,627
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D1105792 | Cibolo Creek | Certificate of waiver | Sep 28, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
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
- Government · Non-profit
- Enrollment address
- 1440 River Road
Boerne, TX 78006-1958 - Nursing home name
- CIBOLO CREEK
All disclosed owners & managing parties 7
| Name | Role | Since | Share |
|---|---|---|---|
| Cascade-Kendall Health Services, LTD |
Operational/Managerial Control | May 1, 2021 | 100% |
| John Trenton Sorrells |
Adp of the SNF | May 1, 2021 | |
| Medina County Hospital District |
5% Or Greater Direct Ownership Interest | May 1, 2021 | 100% |
| Ronald M Haney |
Operational/Managerial Control |
May 1, 2021 | 50% |
| Adp of the SNF | May 1, 2021 | ||
| Boerne HC LLC |
Adp of the SNF | May 1, 2021 | |
| Taylor Collier |
Adp of the SNF | Aug 22, 2023 | |
| Billie Bell |
Corporate Officer |
Jun 3, 2023 |
All facility ownership & control disclosures 8
| Facility | Type | Role | Since |
|---|---|---|---|
| Town and Country Nursing and Rehabilitation Center |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jun 1, 2014 |
| Medina Valley Health & Rehabilitation Center |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Aug 1, 2014 |
| Guadalupe Valley Nursing and Rehabilitation Center |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Adp of the SNF |
Jun 1, 2014 Jan 15, 2026 |
| Las Colinas of Westover |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 31, 2017 |
| Windcrest Nursing and Rehabilitation |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | May 1, 2025 |
| Medical Clinic of Castroville |
Rural health clinic | 5% Or Greater Direct Ownership Interest | Oct 1, 2009 |
| Medical Clinic of Hondo |
Rural health clinic | 5% Or Greater Direct Ownership Interest | Oct 1, 2009 |
| Medical Clinic of Devine |
Rural health clinic | 5% Or Greater Direct Ownership Interest | Oct 1, 2009 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210707003557 | TX | Part a Provider - Skilled Nursing Facility | 6709932049 | Practice locations: Boerne, TX |
National Provider Directory
- Tax ID family
- Medina Regional Hospital
Locations
1440 River Rd
#1958
Boerne, TX 78006
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
1440 River Rd
Boerne, TX 78006-9998
Mailing address
1440 River Rd
Boerne, TX 78006-9998
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001017625 | Medicaid | TX | |
| 001031685 | Medicaid | TX |
Other names
- Cibolo Creek
Other providers in Boerne, TX
- Medcare Associates, P.a.
- Medflex Health Solutions LLC
- Medical Outpost PLLC
- Medina County Hospital District
- Medina County Hospital District
- Marcos Javier Medina-Sanchez
- Martha Medrano
- Memorial EMS Services
- Jacqueline Mendez
- Angela Menke
All providers in Boerne, TX · Skilled Nursing Facility in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.