NPIMap

Organization Active NPI

Dallas County Hospital District

Doing business as Canton Oaks

  • Skilled Nursing Facility
  • Canton, TX
National Provider Identifier
1417255233
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
DALLAS COUNTY HOSPITAL DISTRICT
Doing business as
Canton Oaks
Practice address
1901 S Trade Days Blvd
Canton, TX 75103
Phone
(903) 567-0444
Fax
(903) 567-0445
NPI assigned
Mar 2, 2011
Last updated
Mar 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Authorized official

Name
Frederick Cerise, MD
Title
Ceo
Phone
(214) 590-8006

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1901 S Trade Days Blvd
Canton, TX 75103

Mailing address

920 Ridgebrook Rd
Sparks, MD 21152-9390
Phone (410) 773-1000

Other identifiers 1

IdentifierTypeStateIssuer
001019566MedicaidTX

Other names 1

  • Canton Oaks Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170527000001 TX Part A Provider - Skilled Nursing Facility 8325934813 Practice locations: Canton, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417255233. Details of each certification follow.

Skilled nursing facility certification: CCN 676300

Legal name
DALLAS COUNTY HOSPITAL DISTRICT
Doing business as
CANTON OAKS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Nov 18, 2011
Last certification
Jun 5, 2024
Beds
120
Ownership / control type
Corporation
Multi-facility organization
Fundamental Clinical and Operational Services
Organization structure
GovernmentNon-profit
Enrollment address
1901 S Trade Days Blvd
Canton Oaks
Canton, TX 75103-1901
Nursing home name
CANTON OAKS
Affiliated entity
FUNDAMENTAL HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Canton OaksCCN 676300 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Nov 18, 2011
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12089.6 residents per day on average
Chain
Fundamental Healthcare66 facilities in the chain
Penalties (3 years)
2Fines totaling $49,111

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Dallas County Hospital Dist95 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Frederick P Cerise Individual Corporate OfficerCeo Apr 1, 2017
Kent M Davis Individual Operational/Managerial Control Apr 1, 2017
Adp of the SNF Apr 1, 2017
Edmundo Castaneda Individual Corporate OfficerEx VP & Coo Jan 10, 2022
Canton Long Term Care, LLC Organization, Canton, TX LLC Operational/Managerial Control Apr 1, 2017
Fundamental Clinical and Operational Services, LLC Organization, Sparks, MD LLC, Consulting firm Adp of the SNF Apr 1, 2017
Fundamental Administrative Services LLC Organization, Sparks, MD LLC, Consulting firm Adp of the SNF Apr 1, 2017
Dallas County Hospital District Organization, Dallas, TX 5% Or Greater Direct Ownership Interest Apr 1, 2017 100%
Douglas Humble Individual Adp of the SNF Apr 1, 2017

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 40

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

FacilityTypeRoleSince
Parkland HealthDallas, TX, CCN 450015 Hospital Operational/Managerial Control Apr 22, 1966
Parkland HealthDallas, TX, CCN 45T015 Hospital Operational/Managerial Control Oct 1, 1983
Parkland HealthDallas, TX, CCN 45S015 Hospital Operational/Managerial Control Oct 1, 1983
Town East Rehabilitation and Healthcare CenterMesquite, TX, CCN 676146 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 23, 2017
The Plaza at RichardsonRichardson, TX, CCN 676098 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (100%) Feb 27, 2015
Williamsburg Village Healthcare CampusDesoto, TX, CCN 675756 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 27, 2015
The Madison on MarshCarrollton, TX, CCN 676128 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 15, 2015
Villa at Mountain ViewDallas, TX, CCN 675783 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 15, 2015
The Manor at SeagovilleSeagoville, TX, CCN 675418 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 15, 2015
Crestview CourtCedar Hill, TX, CCN 676112 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 15, 2015
Prairie EstatesFrisco, TX, CCN 676145 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 15, 2015
Windsor GardensLancaster, TX, CCN 455832 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 15, 2015
Duncanville Healthcare and Rehabilitation CenterDuncanville, TX, CCN 676178 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Feb 21, 2015
Feb 21, 2015
Brentwood Place FourDallas, TX, CCN 676270 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 20, 2015
Meadowbrook Care CenterVan Alstyne, TX, CCN 675151 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Avir at River ValleyGainesville, TX, CCN 455970 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2019
The Terrace at DenisonDenison, TX, CCN 455806 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 1, 2017
Apr 1, 2017
Ridgeview RehabilitationCleburne, TX, CCN 676197 Skilled nursing facility Operational/Managerial Control (100%) Mar 31, 2017
Avir at ShermanSherman, TX, CCN 676120 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 31, 2017
Avir at North Richland HillsNorth Richland Hills, TX, CCN 676127 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 31, 2017
Corinth Rehabilitation Suites on the ParkwayCorinth, TX, CCN 676319 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Lakewest Rehabilitation and Skilled CareDallas, TX, CCN 676276 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 31, 2017
Edgewood Rehabilitation and Care CenterMesquite, TX, CCN 676326 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Prestonwood Rehabilitation & Nursing CenterPlano, TX, CCN 676156 Skilled nursing facility Operational/Managerial Control Apr 1, 2017
Forest Park Nursing & RehabilitationDallas, TX, CCN 676293 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2022
The Hillcrest of North DallasDallas, TX, CCN 676315 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Sandy Lake Rehabilitation and Care CenterCoppell, TX, CCN 676247 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Mira Vista CourtFort Worth, TX, CCN 676067 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017
Ridgecrest Healthcare and Rehabilitation CenterForney, TX, CCN 676275 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 1, 2017
Apr 1, 2017
Denton RehabDenton, TX, CCN 675136 Skilled nursing facility Operational/Managerial Control (100%) Apr 1, 2017
Beacon HillDenison, TX, CCN 675503 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2019
Renaissance Care CenterGainesville, TX, CCN 675441 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2019
The Belmont at Twin CreeksAllen, TX, CCN 676237 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2019
San RemoRichardson, TX, CCN 676256 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2019
The Carlyle at Stonebridge ParkSouthlake, TX, CCN 676249 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2019
The Harrison at HeritageFort Worth, TX, CCN 676317 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2019
CarraraPlano, TX, CCN 676429 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2020
Palomino PlaceMesquite, TX, CCN 676422 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2020
Las Brisas Rehabilitation and Wellness CenterIrving, TX, CCN 676464 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2025
The StewpotDallas, TX, CCN 741836 Federally qualified health center Operational/Managerial Control Jan 1, 2022

Facilities with the same owner 40

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

View all 40

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": "1299024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583798400000",
    "number": "1417255233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 RIDGEBROOK RD",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529390",
            "telephone_number": "410-773-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 S TRADE DAYS BLVD",
            "city": "CANTON",
            "state": "TX",
            "postal_code": "75103",
            "telephone_number": "903-567-0444",
            "fax_number": "903-567-0445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALLAS COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-02",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A",
        "authorized_official_last_name": "CERISE",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-590-8006",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001019566",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canton Oaks",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Canton Oaks",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canton, TX

Sources for this page

Verify at the official NPI Registry.