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Organization Active NPI

Scott & White Hospital Brenham

  • Medicare Defined Swing Bed Hospital Unit
  • Brenham, TX
National Provider Identifier
1659949121
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
SCOTT & WHITE HOSPITAL BRENHAM
Practice address
700 Medical Pkwy
Brenham, TX 77833-5413
Phone
(979) 337-5000
Fax
(979) 830-2244
NPI assigned
Jun 11, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Authorized official

Name
Jason D Jennings
Title
Ceo
Phone
(979) 207-4043

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary
Critical Access Hospital 282NC0060X

Addresses

Primary practice location

700 Medical Pkwy
Brenham, TX 77833-5413

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Other names 1

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230530003179 TX Part A Provider - Critical Access Hospital 5799719787 Practice locations: Brenham, TX

Hospital certification: CCN 45Z397

Legal name
SCOTT & WHITE HOSPITAL BRENHAM
Doing business as
BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM
Organization structure
OtherNon-profit
Incorporated
Feb 28, 1989 in TX
Enrollment address
700 Medical Pkwy
Brenham, TX 77833-5413
Hospital Swing-Bed Unit

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

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Justin Meier Individual Operational/Managerial ControlSVP Corporate Finance Feb 9, 2023
Scott & White Healthcare Organization, Temple, TX Non-profit Operational/Managerial Control Jul 1, 2010
Matt Bentke Individual Operational/Managerial ControlTrustee Jul 1, 2018
Wendy Ragonis Anderson Individual Operational/Managerial ControlTrustee Sep 25, 2020
Baylor Scott & White Health Organization, Temple, TX Corporation Operational/Managerial Control Mar 1, 2014
Candice Bullock Individual Operational/Managerial ControlTrustee Jul 1, 2021
Tieman III Dippel Individual Operational/Managerial ControlTrustee Aug 16, 2024
Michael Hopkins Individual Operational/Managerial ControlTrustee Jul 1, 2018
Jim Kruse Individual Operational/Managerial ControlTrustee Jul 1, 2016
William L Rayburn Individual Operational/Managerial ControlTrustee Jul 1, 2010
Noe B Gutierrez Individual W-2 Managing EmployeeCfo Feb 28, 2022
Operational/Managerial ControlCeo Feb 28, 2022
Jason David Jennings Individual W-2 Managing EmployeeCeo Feb 25, 2013
Operational/Managerial ControlCeo Feb 25, 2013
Seth J Sullivan Individual Operational/Managerial ControlTrustee Dec 2, 2022
Shirley Herring Individual Operational/Managerial ControlTrustee Jul 1, 2016
Baylor Scott & White Holdings Organization, Dallas, TX Corporation Operational/Managerial Control Mar 1, 2014

Owners & managing parties with NPI records 2

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

Facilities with the same owner 36

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

View all 36

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1623369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690848000000",
    "number": "1659949121",
    "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": "700 MEDICAL PKWY",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778335413",
            "telephone_number": "979-337-5000",
            "fax_number": "979-830-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT & WHITE HOSPITAL BRENHAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-11",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "979-207-4043"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brenham, TX

Sources for this page

Verify at the official NPI Registry.