King'S Manor Methodist Retirement System, Inc.

Key facts

NPI: 1417902016
Entity type: Organization (NPI type 2)
Primary specialty: Community Based Hospice Care Agency 251G00000X
License: 008786 (TX)
Legal business name: KING'S MANOR METHODIST RETIREMENT SYSTEM, INC.
Practice address: 400 Ranger St
Hereford, TX 79045-2812
Phone: (806) 363-6085
Fax: (806) 363-6038
NPI assigned: May 23, 2006
Organization subpart: No

Authorized official

Name: Christine Marie Batenhorst
Title: Hospice Administrator
Phone: (806) 363-6085

Owners & managing parties with NPI records 1

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

Shelly Osborn Moss Clinical Social Worker · Hereford, TX · NPI 1598552960

CMS ownership W-2 MANAGING EMPLOYEE

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Christine Marie Batenhorst, LBSW Case Manager/Care Coordinator · Hereford, TX · NPI 1568655322

NPD
Shelly Osborn Moss Clinical Social Worker · Hereford, TX · NPI 1598552960

NPD

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Ron K. Rankin, M.D. Family Medicine Physician · Amarillo, TX · NPI 1861405250

Care Compare affiliation Hospice
Trevor Rohm, MD Family Medicine Physician · Hereford, TX · NPI 1780723791

Care Compare affiliation Hospice

Medicare Care Compare: Hospice

Listed as: Samaritan Hospice CCN 451782
Ownership: For-Profit
Certified: Dec 21, 2004
Medicare certification status: Active (Provider of Services file)

Source: Medicare Care Compare.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
45D2184855	Samaritan Hospice 400 Ranger, Room 102, Hereford, TX 79045	Certificate of waiver	May 25, 2028

Medicare participation

Medicare fee-for-service enrollment: Enrolled in TX

Hospice certification: CCN 451782

Legal name: KING'S MANOR METHODIST RETIREMENT SYSTEM, INC.
Doing business as: KING'S MANOR METHODIST HOME; SAMARITAN HOSPICE
Certification status: Active
Provider type (POS): Hospice
Participating since: Dec 21, 2004
Last certification: Sep 11, 2020
Ownership / control type: Non-Profit - Other
Organization structure: Corporation · Non-profit
Incorporated: Aug 26, 1997 in TX
Enrollment address: 400 Ranger St
Hereford, TX 79045-2812

All disclosed owners & managing parties 12

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

Name	Role	Since	Share
Julia Laing Individual	Corporate Director Member of the Board of Directors	Feb 1, 1995	14.2%
John Perrin Individual	Corporate Director Board Member	May 1, 2002	14.2%
Dan Higgins Individual	Corporate Director Chairman of Board of Directors	Feb 1, 1997	16%
Christine M Batenhorst Individual	W-2 Managing Employee Samarita Hospice Administrator	May 20, 2018
James Layman Individual	W-2 Managing Employee Cheif Financial Officer	Jun 16, 2008
Stoney Gleisner Individual	Corporate Officer Ceo	Jun 28, 2018
Stoney Gleisner Individual	W-2 Managing Employee Ceo	Jun 28, 2018
Shelly Osborn Moss Individual	W-2 Managing Employee Executive Director	Mar 9, 2007
King'S Manor Methodist Retirement System, Inc. Organization · Hereford, TX Corporation, Non-profit	Operational/Managerial Control	Dec 31, 2003	100%
Steven B Carlson Individual	Corporate Director Board Member	Feb 22, 2018	14.2%
Rex Keeling Individual	Corporate Director Member of the Board of Directors	Apr 28, 2011	14.2%
Brenda Fuentes Individual	Corporate Director Member of the Board of Directors	Apr 28, 2011	14.2%
Mike Carr Individual	Corporate Director Member of the Board of Directors	Apr 28, 2011	14.2%

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20101026000172	TX	Part a Provider - Hospice	6507753530	Practice locations: Hereford, TX

National Provider Directory

Locations

426 Main St
Ste E
Hereford, TX 79045
Phone (806) 363-6085

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Community Based Hospice Care Agency	251G00000X	008786	TX	Yes
Inpatient Hospice	315D00000X	008786	TX

Addresses

Primary practice location

400 Ranger St
Hereford, TX 79045-2812

Mailing address

PO Box 1999
Hereford, TX 79045-1999
Phone (806) 364-0661

Other identifiers

Identifier	Type	State	Issuer
001013186	Medicaid	TX

Other names

SAMARITAN HOSPICE Doing business as

Other providers in Hereford, TX

All providers in Hereford, TX · Community Based Hospice Care Agency 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 10, 2024. 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.

Verify at the official NPI Registry.