NPIMap

Organization Active NPI

Scott & White Hospital - Taylor

Doing business as Baylor Scott & White Medical Center - Taylor

  • Emergency Medicine Physician
  • Taylor, TX
National Provider Identifier
1659366557
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
44 Issued in TX
Legal business name
SCOTT & WHITE HOSPITAL - TAYLOR
Doing business as
Baylor Scott & White Medical Center - Taylor
Practice address
305 Mallard LN
Taylor, TX 76574-1208
Phone
(512) 352-7611
Fax
(512) 352-4734
NPI assigned
Sep 16, 2005
Last updated
Jan 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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

Authorized official

Name
Jay Fox
Title
Ceo
Phone
(512) 509-0409

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X 44 TX Primary
Critical Access Hospital 282NC0060X 44 TX

Addresses

Primary practice location

305 Mallard LN
Taylor, TX 76574-1208

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Other names 1

  • BAYLOR SCOTT & WHITE MEDICAL CENTER - TAYLOR Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040217000059 TX Part B Supplier - Clinic/Group Practice 1456246750 Receives reassigned benefits from 118 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Taylor, TX
O20061104000609 TX Part A Provider - Critical Access Hospital 1456246750 Receives reassigned benefits from 91 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Taylor, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659366557. Details of each certification follow.

Hospital certification: CCN 451374

Legal name
SCOTT & WHITE HOSPITAL - TAYLOR
Doing business as
BAYLOR SCOTT & WHITE MEDICAL CENTER - TAYLOR
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Dec 20, 2005
Last certification
Nov 7, 2025
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
OtherNon-profit
Incorporated
Oct 20, 1967 in TX
Enrollment address
305 Mallard LN
Taylor, TX 76574-1208
Main/Primary Hospital Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Baylor Scott & White Medical Center -TaylorCCN 451374 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations (25 of 123)

13001 E 17th Pl
Rm WG109
Aurora, CO 80045

300 S Jackson St
Ste 340
Denver, CO 80209
Phone (303) 316-0416

2401 W Horizon Ridge Pkwy
Ste 10
Henderson, NV 89052

401 Wood St
Ste 903
Pittsburgh, PA 15222

10815 Ranch Road 2222
Ste 100
Austin, TX 78730
Phone (512) 327-4262

10815 Ranch Road 2222
Ste A-100
Austin, TX 78730
Phone (512) 327-4262

12129 FM 620 N
Ste 600
Austin, TX 78750

12129 Ranch Road 620 N
#600E
Austin, TX 78750
Phone (512) 336-3400

200 E Cesar Chavez St
Austin, TX 78701
Phone (512) 654-4100

200 E Cesar Chavez St
Ste G140
Austin, TX 78701
Phone (512) 509-0030

2217 Park Bend Dr
Ste 2
Austin, TX 78758

2217 Park Bend Dr
Ste 230
Austin, TX 78758
Phone (512) 220-5401

3207 Ranch Road 620 S
Austin, TX 78738
Phone (512) 730-3885

4310 James Casey St
Ste A
Austin, TX 78745
Phone (512) 504-7411

500 Canyon Ridge Dr
Ste 208
Austin, TX 78753
Phone (512) 654-7800

500 W Slaughter LN Ste 100
Austin, TX 78748

5000 W Slaughter Ln
Austin, TX 78749
Phone (512) 654-4000

5000 W Slaughter Ln
Bldg 6
Austin, TX 78749

5251 W Highway 290
Ste 100
Austin, TX 78735
Phone (512) 654-4319

9521 W US Highway 290
Ste 105
Austin, TX 78736
Phone (512) 654-4300

16018 W Highway 71 Pass
Bee Cave, TX 78738
Phone (512) 654-3900

1505 N Main St
Belton, TX 76513
Phone (254) 933-4000

604 Highway 290 W
Brenham, TX 77833
Phone (979) 251-8005

604 Highway 290 W
Ste 301
Brenham, TX 77833
Phone (979) 421-2000

605 Medical Pkwy Ste 101
Brenham, TX 77833

Ownership & related parties

All disclosed owners & managing parties 24

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

NameRoleSinceShare
William Rogers Individual Operational/Managerial ControlTrustee Jul 1, 2015
Justin Meier Individual Operational/Managerial ControlSVP Corporate Finance Feb 9, 2023
Mark L Montgomery Individual Operational/Managerial ControlTrustee Jul 1, 2015
Morris E Foster Individual Operational/Managerial ControlTrustee Jul 1, 2015
Mark W English Individual Operational/Managerial ControlTrustee Jul 1, 2022
Tresa Muir McNeal Individual Operational/Managerial ControlTrustee Nov 30, 2017
Scott & White Healthcare Organization, Temple, TX Corporation Operational/Managerial Control Sep 1, 2010
Thomas Burdett Individual Operational/Managerial ControlTrustee Jul 1, 2015
Terry Maness Individual Operational/Managerial ControlTrustee Feb 23, 2019
Baylor Scott & White Health Organization, Temple, TX Non-profit Operational/Managerial Control Mar 1, 2014
Dominic Lucia Individual Operational/Managerial ControlTrustee Dec 4, 2020
William D Digaetano Individual Operational/Managerial ControlTrustee Jul 1, 2019
Muralidhar Jatla Individual Operational/Managerial ControlTrustee Jul 1, 2023
Jim Kruse Individual Operational/Managerial ControlTrustee Jul 1, 2015
Nelda Trevino Individual Operational/Managerial ControlTrustee Dec 4, 2020
Jason Cole Individual Corporate DirectorCfo Jul 30, 2007
W-2 Managing EmployeeCfo Jul 30, 2007
Operational/Managerial ControlCfo Jul 30, 2007
Aval-NA'Ree S Green Individual Operational/Managerial ControlTrustee Jul 1, 2023
Angel Eduardo Caldera Individual Operational/Managerial ControlTrustee Nov 30, 2017
Arundhati Rao Individual Operational/Managerial ControlTrustee Dec 4, 2020
Kristen Leslie Manos Individual Corporate DirectorBoard Director Jul 1, 2025
Andra Liemandt Individual Operational/Managerial ControlTrustee Jul 1, 2023
Jarvis Parsons Individual Operational/Managerial ControlTrustee Jul 1, 2024
Megan Kiella Individual Corporate DirectorBoard Director Jul 1, 2025
Jay Fox Individual Corporate DirectorCeo Oct 1, 2014
W-2 Managing EmployeeCeo Oct 1, 2014
Operational/Managerial ControlCeo Oct 1, 2014

Owners & managing parties with NPI records 8

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

Practitioners & affiliated clinicians

Practitioners 2,752

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.

View all 2,752

Affiliated clinicians 159

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 159

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579651200000",
    "number": "1659366557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MALLARD LN",
            "city": "TAYLOR",
            "state": "TX",
            "postal_code": "765741208",
            "telephone_number": "512-352-7611",
            "fax_number": "512-352-4734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT & WHITE HOSPITAL - TAYLOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-16",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-509-0409"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "44",
            "primary": true
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "TX",
            "license": "44",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BAYLOR SCOTT & WHITE MEDICAL CENTER - TAYLOR",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BAYLOR SCOTT & WHITE MEDICAL CENTER - TAYLOR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Taylor, TX

Sources for this page

Verify at the official NPI Registry.