Active NPI
SLP Willis LLC
- Skilled Nursing Facility
- Willis, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- SLP WILLIS LLC
- Practice address
- 3000 N Danville St
Willis, TX 77378-3490 - Phone
- (936) 856-4312
- Fax
- (936) 856-4364
- NPI assigned
- Jul 21, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Richard Agnew
- Title
- Authorized Official
- Phone
- (512) 565-6159
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
3000 N Danville St
Willis, TX 77378-3490
Mailing address
3000 N Danville St
Willis, TX 77378-3490
Phone (936) 856-4312
Other names 1
- Willis Nursing and Rehabilitation
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210429001825 | TX | Part A Provider - Skilled Nursing Facility | 8325467756 | Practice locations: Willis, TX |
Skilled nursing facility certification: CCN 675274
- Legal name
- SLP WILLIS LLC
- Doing business as
- WILLIS NURSING AND REHABILITATION
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Feb 2, 1994
- Last certification
- Jun 28, 2024
- Beds
- 114
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Senior Living Properties
- Organization structure
- LLC
- Enrollment address
- 3000 N Danville St
Willis, TX 77378-3490 - Nursing home name
- WILLIS NURSING AND REHABILITATION
- Affiliated entity
- SLP OPERATIONS
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Willis Nursing and Rehabilitation
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Feb 2, 1994
- Medicare certification status
- Active
- Certified beds
- 114
- Chain
- SLP Operations
- Penalties (3 years)
- 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D0722472 | SLP Willis, LLC | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
300 N Danville St
Willis, TX 77378
Phone (936) 856-4312
Ownership & related parties
All disclosed owners & managing parties 13
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 |
|---|---|---|---|
| Gary Whitworth | 5% Or Greater Indirect Ownership Interest | Jun 1, 2023 | 33.77% |
| SLP Omega Operations, LLC | 5% Or Greater Direct Ownership Interest | Jun 1, 2023 | 100% |
| Darren Boswell | 5% Or Greater Indirect Ownership Interest | Jun 1, 2023 | 33.77% |
| Senior Living Properties LLC | 5% Or Greater Indirect Ownership Interest | Jun 1, 2023 | 100% |
| Willis Texas Aviv LLC | 5% Or Greater Security Interest | Aug 1, 2020 | 100% |
| Adp of the SNF | Aug 1, 2020 | ||
| SLP Operations, LLC | 5% Or Greater Indirect Ownership Interest | Jun 1, 2023 | 100% |
| Milton Guerrero | Operational/Managerial Control | Mar 25, 2013 | |
| Adp of the SNF | Mar 25, 2013 | ||
| Joshua Leonard | Corporate Officer | Oct 1, 2024 | |
| Operational/Managerial Control | Oct 1, 2024 | ||
| Adp of the SNF | Aug 1, 2020 | ||
| James E. Eden | 5% Or Greater Indirect Ownership Interest | Jun 1, 2023 | 32.47% |
| Adp of the SNF | Aug 1, 2020 | ||
| SLP Management Holdings, LLC | 5% Or Greater Indirect Ownership Interest | Jun 1, 2023 | 67.53% |
| Laronda Simmons | Adp of the SNF | Feb 18, 2021 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Geriatric Medicine (Family Medicine) Physician
- Houston, TX
- NPI 1548232317
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 3
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Conroe, TX
- NPI 1013525567
Senior Living Properties LLC, SLP Management Holdings, LLC, SLP Omega Operations, LLC, SLP Operations, LLC
-
- Skilled Nursing Facility
- Diboll, TX
- NPI 1942818489
Senior Living Properties LLC, SLP Management Holdings, LLC, SLP Omega Operations, LLC, SLP Operations, LLC
-
- Skilled Nursing Facility
- Levelland, TX
- NPI 1265070254
Senior Living Properties LLC, SLP Management Holdings, LLC, SLP Omega Operations, LLC, SLP Operations, LLC
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Geriatric Medicine (Family Medicine) Physician
- Houston, TX
- NPI 1548232317
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Family Medicine) Physician
- Houston, TX
- NPI 1548232317
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595289600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1751241600000",
"number": "1568070001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 N DANVILLE ST",
"city": "WILLIS",
"state": "TX",
"postal_code": "773783490",
"telephone_number": "936-856-4312",
"fax_number": "936-856-4364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 N DANVILLE ST",
"city": "WILLIS",
"state": "TX",
"postal_code": "773783490",
"telephone_number": "936-856-4312",
"fax_number": "936-856-4364"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SLP WILLIS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-07-21",
"last_updated": "2025-06-30",
"certification_date": "2025-06-30",
"status": "A",
"authorized_official_last_name": "AGNEW",
"authorized_official_first_name": "RICHARD",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "512-565-6159"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Willis Nursing and Rehabilitation",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Willis Nursing and Rehabilitation",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Willis, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.