Organization Active NPI

Clarendon NH Operations

  • Skilled Nursing Facility
  • Clarendon, TX
National Provider Identifier
1447619663
Registry record updated Jan 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
146235 Issued in TX
Legal business name
CLARENDON NH OPERATIONS
Practice address
Ten Medical Center Drive
Clarendon, TX 79226
Phone
(937) 459-2297
NPI assigned
Feb 16, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2017

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

Authorized official

Name
Mr. Scott Spore
Title
Ceo
Phone
(806) 637-7561

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 146235 TX Primary

Addresses

Primary practice location

Ten Medical Center Drive
Clarendon, TX 79226

Mailing address

Ten Medical Center Drive
Clarendon, TX 79226
Phone (806) 874-5221

Other identifiers 1

IdentifierTypeStateIssuer
004918MedicaidTX

Other names 1

  • CLARENDON NURSING HOME Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170202002028 TX Part A Provider - Skilled Nursing Facility 6305129099 Practice locations: Clarendon, TX

Skilled nursing facility certification: CCN 676411

Legal name
CLARENDON NH OPERATIONS
Doing business as
CLARENDON NURSING HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Feb 2, 2017
Last certification
Oct 30, 2024
Beds
61
Ownership / control type
Corporation
Multi-facility organization
Theora Management
Organization structure
PartnershipProprietary
Enrollment address
10 Medical Center Drive
Clarendon, TX 79226-6046
Nursing home name
CLARENDON NURSING HOME

Care Compare: Nursing home

Medicare Care Compare
Listed as
Clarendon Nursing HomeCCN 676411
Overall star rating
3 of 5
Health inspections
4 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Feb 2, 2017
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6158.8 residents per day on average
Penalties (3 years)
2Fines totaling $7,551

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
45D2194264Clarendon Nursing Home10 Medical Center Drive, Clarendon, TX 79226Certificate of waiverSep 28, 2026

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Roger J Wolcott Individual 5% Or Greater Indirect Ownership InterestMember Mar 1, 2016 10%
Limited Partnership InterestLimited Partner of Clarendon NH Mar 1, 2016 10%
Indirect Ownership Interest Mar 1, 2016
SSS Holdings LP Organization, Brownfield, TX Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2016 25%
Limited Partnership Interest Mar 1, 2016 25%
Adp of the SNF Jan 23, 2025
Indirect Ownership Interest Feb 1, 2016
Jim E Bullard Individual 5% Or Greater Indirect Ownership InterestMember Mar 1, 2016 25%
Limited Partnership InterestLimited Partner Mar 1, 2016 25%
Corporate DirectorBoard Member of Theora Managemen Mar 1, 2016 34%
Indirect Ownership Interest Mar 1, 2016
Scott S Spore Individual 5% Or Greater Indirect Ownership InterestMember Mar 1, 2016 49.5%
Limited Partnership InterestLimited Partner for SSS Holdings Mar 1, 2016 49.5%
Corporate DirectorBoard Member of Theora Managemen Mar 1, 2016 33%
W-2 Managing EmployeeMember Mar 1, 2016
Indirect Ownership Interest Mar 1, 2016
Cathy Myers Individual W-2 Managing EmployeeAd; Dec 1, 2023
Adp of the SNF Jan 23, 2025
Paul F Chebib Individual 5% Or Greater Direct Ownership InterestOwner of Paul Chebib Mdpa Mar 1, 2016 100%
Limited Partnership InterestBoard Member OD Theora Managemen Mar 1, 2016 15%
W-2 Managing EmployeeMD; Mar 1, 2016
Adp of the SNF Jan 23, 2025
Indirect Ownership Interest Mar 1, 2016
Theora Management Systems Inc Organization, Brownfield, TX Corporation, For-profit, Owned by another organization or individual General Partnership Interest Mar 1, 2016
Indirect Ownership Interest Feb 1, 2016
Carl L Britton Individual 5% Or Greater Direct Ownership InterestPresident of Carl Lee Britton MD Mar 1, 2016 100%
Limited Partnership InterestMember Dec 1, 2023 25%
Direct Ownership Interest Mar 1, 2016 25%
Clarendon NH Operations Organization, Brownfield, TX Owned by another organization or individual 5% Or Greater Direct Ownership Interest Mar 1, 2016
Operational/Managerial Control Mar 1, 2016 100%
Adp of the SNF Jan 23, 2025
Direct Ownership Interest Feb 1, 2016 4.99%
Dr Paul Chebib MD PA Organization, Brownfield, TX Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2016 15%
Limited Partnership Interest Mar 1, 2016 10%
Adp of the SNF Jan 23, 2025
Indirect Ownership Interest Feb 1, 2016 15%
Carl Lee Britton Mdpa Organization, Lubbock, TX Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2016 25%
Limited Partnership Interest Mar 1, 2015 25%
Adp of the SNF Jan 23, 2025
Indirect Ownership Interest Feb 1, 2016

Owners & managing parties with NPI records 5

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 2

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

Affiliated clinicians 1

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": "1455580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483401600000",
    "number": "1447619663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "TEN MEDICAL CENTER DRIVE",
            "city": "CLARENDON",
            "state": "TX",
            "postal_code": "79226",
            "telephone_number": "806-874-5221",
            "fax_number": "806-874-5619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TEN MEDICAL CENTER DRIVE",
            "city": "CLARENDON",
            "state": "TX",
            "postal_code": "79226",
            "telephone_number": "937-459-2297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARENDON NH OPERATIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-16",
        "last_updated": "2017-01-03",
        "status": "A",
        "authorized_official_last_name": "SPORE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "806-637-7561",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "146235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004918",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLARENDON NURSING HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarendon, TX

Sources for this page

Verify at the official NPI Registry.