NPIMap

Organization Active NPI

Scott & White Memorial Hospital

Doing business as Baylor Scott & White Hospice - Temple

  • Community Based Hospice Care Agency
  • Temple, TX
National Provider Identifier
1447215645
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
SCOTT & WHITE MEMORIAL HOSPITAL
Doing business as
Baylor Scott & White Hospice - Temple
Practice address
5701 Airport Rd
Pod M 195
Temple, TX 76502-7048
Phone
(254) 724-4090
NPI assigned
Apr 19, 2006
Last updated
Aug 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Authorized official

Name
Christopher L Olsen
Title
Cfo
Phone
(254) 724-4556

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X NU Primary

Addresses

Primary practice location

5701 Airport Rd
Pod M 195
Temple, TX 76502-7048

Mailing address

PO Box 847788
Dallas, TX 75284-7788
Phone (254) 724-2111

Other identifiers 2

IdentifierTypeStateIssuer
001001129MedicaidTX
HH044COtherTXBLUE CROSS

Other names 1

  • Baylor Scott & White Hospice - Temple Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080918000633 TX Part A Provider - Hospice 8123076015 Practice locations: Temple, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447215645. Details of each certification follow.

Hospice certification: CCN 451691

Legal name
SCOTT & WHITE MEMORIAL HOSPITAL
Doing business as
BAYLOR SCOTT & WHITE HOSPICE - TEMPLE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 17, 1998
Last certification
Jul 29, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 23, 1949 in TX
Enrollment address
5701 Airport Rd
Pod M195
Temple, TX 76502-7092

Other NPIs with the same Medicare PAC ID 6

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Baylor Scott & White Hospice - TempleCCN 451691 · All quality measures
Ownership
For-Profit
Certified
Dec 17, 1998
Medicare certification status
ActiveFrom the Provider of Services file

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
45D2182461Baylor Scott & White - Temple West Campus5701 Airport Rd Ste 136, Temple, TX 76502AccreditationFeb 21, 2027

National Provider Directory

National Provider Directory
Tax ID family
Scott and White Hospital16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

5701 Airport Rd
#195
Temple, TX 76502
Phone (254) 724-4090

Ownership & related parties

All disclosed owners & managing parties 25

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

NameRoleSinceShare
William Rogers Individual Operational/Managerial ControlTrustee Jul 1, 2015
Mark L Montgomery Individual Operational/Managerial ControlTrustee Nov 1, 2015
Morris E Foster Individual Operational/Managerial ControlTrustee Jul 1, 2015
Mark W English Individual Operational/Managerial ControlTrustee Jul 1, 2022
Gregory Haralson Individual Corporate DirectorCeo Jan 16, 2024
W-2 Managing EmployeeCeo Jan 16, 2024
Operational/Managerial ControlCeo Jan 16, 2024
Tresa Muir McNeal Individual Operational/Managerial ControlTrustee Nov 30, 2017
Scott & White Healthcare Organization, Temple, TX Non-profit Operational/Managerial Control Feb 25, 2009
Christopher Olsen Individual Corporate DirectorCfo Apr 17, 2023
W-2 Managing EmployeeCfo Apr 17, 2023
Operational/Managerial ControlCfo Apr 17, 2023
Thomas Burdett Individual Operational/Managerial ControlTrustee Jul 1, 2015
Terry Maness Individual Operational/Managerial ControlTrustee Feb 23, 2019
Baylor Scott & White Health Organization, Temple, TX Non-profit Operational/Managerial Control Mar 1, 2014
Dominic Lucia Individual Operational/Managerial ControlTrustee Dec 4, 2020
William D Digaetano Individual Operational/Managerial ControlTrustee Jul 1, 2019
Muralidhar Jatla Individual Operational/Managerial ControlTrustee Jul 1, 2023
Jim Kruse Individual Operational/Managerial ControlTrustee Jul 1, 2015
Nelda Trevino Individual Operational/Managerial ControlTrustee Dec 4, 2020
Sairin Maredia Individual Corporate DirectorInterim Hospice Director Apr 19, 2025
OtherHospice Manager Oct 17, 2021
Aval-NA'Ree S Green Individual Operational/Managerial ControlTrustee Jul 1, 2023
Angel Eduardo Caldera Individual Operational/Managerial ControlTrustee Nov 30, 2017
Arundhati Rao Individual Operational/Managerial ControlTrustee Dec 4, 2020
Kristen Leslie Manos Individual Corporate DirectorBoard Director Jul 1, 2025
Andra Liemandt Individual Operational/Managerial ControlTrustee Jul 1, 2023
Jarvis Parsons Individual Operational/Managerial ControlTrustee Jul 1, 2024
Megan Kiella Individual Corporate DirectorBoard Director Jul 1, 2025
Baylor Scott & White Holdings Organization, Dallas, TX Non-profit Other Mar 1, 2014

Owners & managing parties with NPI records 8

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

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Baylor Scott & White Medical Center HillcrestWaco, TX, CCN 45T101 Hospital Operational/Managerial Control Jan 1, 2025
Adventhealth Central TexasKilleen, TX, CCN 450152 Hospital 5% Or Greater Direct Ownership Interest (32%) Jul 1, 2008
Adventhealth Rollins BrookLampasas, TX, CCN 451323 Hospital 5% Or Greater Direct Ownership Interest (32%) Jul 1, 2008
Adventhealth Rollins Brook Swing Bed Skilled Nursing FacilityLampasas, TX, CCN 45Z323 Hospital 5% Or Greater Direct Ownership Interest (32%) Jul 1, 2008
Adventhealth Family Medicine Clinic Copperas CoveCopperas Cove, TX, CCN 673920 Rural health clinic 5% Or Greater Direct Ownership Interest (32%) Jul 1, 2008
Adventhealth Family Medicine Clinic LampasasLampasas, TX, CCN 458905 Rural health clinic 5% Or Greater Direct Ownership Interest (32%) Jul 1, 2008

Owned or controlled facilities with NPI records 7

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

Facilities with the same owner 36

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

View all 36

Practitioners & affiliated clinicians

Affiliated clinicians 5

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": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722470400000",
    "number": "1447215645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847788",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847788",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 AIRPORT RD",
            "address_2": "POD M 195",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765027048",
            "telephone_number": "254-724-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT & WHITE MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A",
        "authorized_official_last_name": "OLSEN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "254-724-4556"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001001129",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "HH044C",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baylor Scott & White Hospice - Temple",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.