NPIMap

Organization Active NPI

Southwest LTC - Corsicana LLC

Doing business as The Village at Heritage Oaks

  • Skilled Nursing Facility
  • Corsicana, TX
National Provider Identifier
1649735036
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SOUTHWEST LTC - CORSICANA LLC
Doing business as
The Village at Heritage Oaks
Practice address
3002 W 2ND Ave
Corsicana, TX 75110-2492
Phone
(903) 872-5130
NPI assigned
Feb 10, 2019
Last updated
Dec 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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

Authorized official

Name
Ronald Payne
Title
Authorized Officer
Phone
(469) 916-6100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3002 W 2ND Ave
Corsicana, TX 75110-2492

Mailing address

5560 Tennyson Pkwy Ste 210
Plano, TX 75024-3582
Phone (469) 916-6100

Other names 1

  • The Village at Heritage Oaks Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190510001087 TX Part A Provider - Skilled Nursing Facility 8325381577 Practice locations: Corsicana, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649735036. Details of each certification follow.

Skilled nursing facility certification: CCN 675581

Legal name
SOUTHWEST LTC - CORSICANA LLC
Doing business as
THE VILLAGE AT HERITAGE OAKS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Apr 24, 1996
Last certification
Sep 18, 2024
Beds
107
Ownership / control type
Corporation
Multi-facility organization
Creative Solutions in Healthcare
Most recent change of ownership
Sep 1, 2025
Organization structure
LLCProprietary
Enrollment address
3002 W 2ND Ave
Corsicana, TX 75110-2492

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Village at Heritage OaksCCN 675581 · All quality measures
Overall star rating
4 of 5
Health inspections
5 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Apr 24, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10752.1 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Ronald R Payne Individual 5% Or Greater Indirect Ownership Interest May 1, 2003 73%
Corporate OfficerManager Apr 1, 2019
Operational/Managerial Control Apr 1, 2019
Rod Baronet Individual 5% Or Greater Indirect Ownership Interest Jan 30, 2003 5.69%
Barry D Hines Individual 5% Or Greater Indirect Ownership Interest Jan 30, 2003 5.69%
Ronald R. Payne P.C Organization, Plano, TX 5% Or Greater Direct Ownership Interest Dec 1, 2004 1%
Southwest LTC, LTD Organization, Plano, TX 5% Or Greater Direct Ownership Interest Dec 1, 2004 99%
Quality Care Givers Inc Organization, Plano, TX Corporation 5% Or Greater Indirect Ownership Interest Dec 1, 2004 11.98%
Craig H Brashier Individual 5% Or Greater Indirect Ownership Interest Dec 1, 2004 9.5%

Facilities with the same owner 9

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, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

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": "1549756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609113600000",
    "number": "1649735036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5560 TENNYSON PKWY STE 210",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243582",
            "telephone_number": "469-916-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3002 W 2ND AVE",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751102492",
            "telephone_number": "903-872-5130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST LTC - CORSICANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-10",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "AUTHORIZED OFFICER",
        "authorized_official_telephone_number": "469-916-6100"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Village at Heritage Oaks",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Village at Heritage Oaks",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corsicana, TX

Sources for this page

Verify at the official NPI Registry.