NPIMap

Organization Active NPI

Cumberland Rest Inc

Doing business as Trinity Terrace

  • Skilled Nursing Facility
  • Fort Worth, TX
National Provider Identifier
1619977246
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
111033 Issued in TX
Legal business name
CUMBERLAND REST INC
Doing business as
Trinity Terrace
Practice address
1600 Texas St
Fort Worth, TX 76102-3400
Phone
(817) 338-2400
Fax
(817) 335-2733
NPI assigned
Jul 26, 2005
Last updated
Jul 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Authorized official

Name
Brian Young
Title
Executive Director
Phone
(817) 233-8736

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 111033 TX Primary

Addresses

Primary practice location

1600 Texas St
Fort Worth, TX 76102-3400

Mailing address

1600 Texas St
Fort Worth, TX 76102-3400
Phone (817) 338-2400

Other names 1

  • Trinity Terrace Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050406000966 TX Part A Provider - Skilled Nursing Facility 5698722189 Practice locations: Fort Worth, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619977246. Details of each certification follow.

Skilled nursing facility certification: CCN 675238

Legal name
THE CUMBERLAND REST INC
Doing business as
TRINITY TERRACE
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Jan 14, 1994
Last certification
Mar 27, 2025
Beds
52
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Pacific Retirement Services
Organization structure
CorporationProprietary
Incorporated
May 26, 1897 in TX
Enrollment address
1600 Texas St
Fort Worth, TX 76102-3400
Nursing home name
TRINITY TERRACE
Affiliated entity
PACIFIC RETIREMENT SERVICES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Trinity TerraceCCN 675238 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare
Ownership
Non profit - Corporation
Certified
Jan 14, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5239.5 residents per day on average
Chain
Pacific Retirement Services10 facilities in the chain

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
45D0485660Trinity Terrace1600 Texas Street, Fort Worth, TX 76102Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

1600 Texas St
Ft Worth, TX 76102
Phone (817) 338-2400

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
James Austin Individual Corporate DirectorBoard Member Dec 18, 2001 10%
Michael McMahon Individual Corporate DirectorBoard Director May 25, 2011 10%
Brian Coulter Individual Corporate DirectorBoard Director Oct 1, 2021 10%
Karl Travis Individual Corporate DirectorBoard Director Dec 18, 2007 10%
Alan Barr Individual Corporate DirectorBoard Director Sep 22, 1998 10%
Andy Taft Individual Corporate DirectorBoard Director Oct 1, 2014 10%
Michael Thomas Individual W-2 Managing EmployeeExecutive Director Jan 7, 2019
OtherExecutive Director Jan 7, 2019
Judy Stempel Individual Corporate DirectorBoard Director Oct 1, 2019 10%
Robert Fernandez Individual Corporate DirectorBoard Director Oct 1, 2014 10%
Don Mills Individual Corporate OfficerBoard Chair Sep 23, 2003
Brian Young Individual Corporate DirectorExecutive Director Jul 1, 2021
Doug Wilson Individual Corporate DirectorBoard Chair Sep 27, 2010 10%
James Whitton Individual Corporate DirectorBoard Director Dec 18, 2001 10%
Gretchen Smith Individual Corporate DirectorBoard Secretary Sep 27, 2010 10%
Pacific Retirement Services Inc Organization, Medford, OR Corporation, Management services company, Non-profit Operational/Managerial Control Nov 1, 1995 100%
Mike Hyatt Individual Corporate DirectorBoard Treasurer Sep 27, 2010 10%
Carlela Vogel Individual Corporate DirectorBoard Director Mar 28, 2006 10%
US Bank National Association Organization, Portland, OR Corporation, Financial institution, For-profit 5% Or Greater Security Interest Dec 29, 2011 100%
Eric Sholty Individual Corporate Officer May 27, 2018

Facilities with the same owner 5

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

Practitioners & affiliated clinicians

Affiliated clinicians 6

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": "1122336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785196800000",
    "number": "1619977246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 TEXAS ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761023400",
            "telephone_number": "817-338-2400",
            "fax_number": "817-335-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 TEXAS ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761023400",
            "telephone_number": "817-338-2400",
            "fax_number": "817-335-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND REST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-26",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "817-233-8736"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "111033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Terrace",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Trinity Terrace",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.