Ascension Providence
Organization Active NPI Rehabilitation Hospital Unit · Waco, TX
NPI 1497559140 · NPPES record last updated Apr 2, 2025
Key facts
- NPI
- 1497559140
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rehabilitation Hospital Unit 273Y00000X
- Legal business name
- ASCENSION PROVIDENCE
- Practice address
- 6901 Medical Parkway
4 East Tower
Waco, TX 76712 - Phone
- (254) 751-4482
- NPI assigned
- Apr 2, 2025
- Organization subpart
- Yes
- Parent organization (as reported)
- ASCENSION PROVIDENCE
Authorized official
- Name
- Philip Patterson
- Title
- Prsident
- Phone
- (254) 751-4482
Owners & managing parties with NPI records 1
-
Dave F Clarke, MD
Owned or controlled facilities with NPI records 1
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 4
Related certifications (CCN) 1
Facilities with the same owner 158
Affiliated clinicians 5
-
John C Biboa, DO
-
Steven M Elwell, MD
-
James R Goodsett, MD
-
Derek Dongwoo Lee, M.D.
-
Barry Shefa, MD
Medicare Care Compare: Inpatient rehabilitation facility
- Listed as
- Ascension Providence
- Ownership
- Non-profit
- Certified
- Jul 1, 2024
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Hospital certification: CCN 45T042
- Legal name
- ASCENSION PROVIDENCE
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 6901 Medical Parkway
Waco, TX 76712-7910 - Hospital subgroups
- Rehabilitation unit
All disclosed owners & managing parties 8
| Name | Role | Since | Share |
|---|---|---|---|
| William Andy Davis |
Corporate Director |
Nov 27, 2017 | |
| W-2 Managing Employee |
Nov 27, 2017 | ||
| Karen Kennards |
Corporate Director | Nov 21, 2024 | |
| Ascension Texas |
Operational/Managerial Control | May 1, 2012 | |
| Ashley M Dickinson |
W-2 Managing Employee |
Aug 1, 2023 | |
| Julie Holly |
Corporate Director |
Nov 5, 2016 | |
| W-2 Managing Employee |
Mar 14, 2013 | ||
| Philip Patterson |
W-2 Managing Employee |
Feb 26, 2018 | |
| Ascension Health |
Operational/Managerial Control | Nov 1, 1999 | |
| Dave F Clarke |
Corporate Director | Jul 1, 2021 |
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Ascension Providence |
Hospital | Operational/Managerial Control (100%) | Aug 29, 2000 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250626001456 | TX | Part a Provider - Hospital | 7517878549 | Practice locations: Waco, TX |
National Provider Directory
- Tax ID family
- Prov HLTH Services of Waco
- Part of
- Prov HLTH Services of Waco
Locations
528 Meadowlake Ctr
Waco, TX 76712
Phone (254) 399-2500
6101 Woodway Dr
Ste 160
Waco, TX 76712
Phone (254) 751-4133
405 Londonderry Dr
Ste 100
Waco, TX 76712
Phone (254) 751-4674
6901 Medical Pkwy
#4E
Waco, TX 76712
Phone (254) 751-4482
311 W Hwy 6
Ste G
Waco, TX 76710
Phone (254) 300-1941
301 Londonderry Dr
Waco, TX 76712
Phone (254) 751-4880
6101 Woodway Dr
Ste 120
Waco, TX 76712
Phone (254) 537-6363
6101 Woodway Dr
Ste 120130
Woodway, TX 76712
Phone (254) 537-6363
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Hospital Unit | 273Y00000X | Yes |
Addresses
Primary practice location
6901 Medical Parkway
4 East Tower
Waco, TX 76712
Mailing address
PO Box 2589
Waco, TX 76702-2589
Other names
- ASCENSION PROVIDENCE SALOME INPATIENT REHABILITATION CENTER
Other providers in Waco, TX
- Don Ray Arterburn
- Louanna G Arterburn
- Kristin M Arterbury
- Ascension Providence
- Ascension Providence
- Ascension Providence
- Hannah Ashley
- Ian Ashley
- Christopher E Asikis
- Monis Aslam
All providers in Waco, TX · Rehabilitation Hospital Unit in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2025. 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.