Organization Active NPI

Brazos Presbyterian Homes Inc.

  • Nursing Facility/Intermediate Care Facility
  • Houston, TX
National Provider Identifier
1679690937
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
117710 Issued in TX
Legal business name
BRAZOS PRESBYTERIAN HOMES INC.
Practice address
4141 S Braeswood Blvd
Houston, TX 77025-3307
Phone
(713) 666-2651
NPI assigned
Mar 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Authorized official

Name
Sheryl Callahan
Title
Ceo
Phone
(713) 660-5012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 117710 TX Primary

Addresses

Primary practice location

4141 S Braeswood Blvd
Houston, TX 77025-3307

Mailing address

4141 S Braeswood Blvd
Houston, TX 77025-3307
Phone (713) 666-2651

Other names 1

  • Bayou Manor Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071024000560 TX Part A Provider - Skilled Nursing Facility 3375630205 Practice locations: Houston, TX

Skilled nursing facility certification: CCN 676282

Legal name
BRAZOS PRESBYTERIAN HOMES INC
Doing business as
BAYOU MANOR
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
May 18, 2011
Last certification
Aug 15, 2024
Beds
37
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Organization Brazos Presbyterian Homes
Organization structure
CorporationNon-profit
Incorporated
Oct 27, 1960 in TX
Enrollment address
4141 S Braeswood Blvd
Bayou Manor
Houston, TX 77025-3307
Nursing home name
BAYOU MANOR

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Bayou ManorCCN 676282
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
May 18, 2011
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3733.5 residents per day on average

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
45D0961805Bayou Manor4141 South Braeswood Boulevard, Houston, TX 77025Certificate of waiverJun 16, 2027

National Provider Directory

National Provider Directory
Tax ID family
Bayou Manor2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Jeanette Wennenweser Individual Corporate Director Jan 1, 2015
John Lemen Individual Corporate Director Jan 1, 2017
Sharon Darden Individual Corporate Director Jan 1, 2022
Judy Lakin Individual Corporate DirectorBoard of Director Board Member Jan 1, 2026
David Elledge Individual Corporate OfficerBoard Member Jan 1, 2025
Michael Cummings Individual Operational/Managerial Control Dec 15, 2025
Adp of the SNF Feb 2, 2026
Richard Leathers Individual Corporate Director Jan 1, 2013
Andy Gans Individual Corporate Director Jan 1, 2018
Locke Braly Individual Corporate OfficerBoard Member Jan 1, 2025
John Hudson Individual Corporate Director Jan 1, 2021
John Hartman Individual Corporate DirectorBoard of Director Board Member Jan 1, 2018
Kathleen Redden Individual Corporate Director Jan 1, 2011
Suzanne McPhail Individual Corporate Director Jan 1, 2018
Deidre Kinsey Individual Corporate OfficerPresident/Ceo Sep 1, 2024
Operational/Managerial Control Sep 1, 2024
Richard Nunn Individual Corporate OfficerTreasurer Jan 1, 2015
Roberto Camacho-Acevedo Individual Adp of the SNF Feb 26, 2024
Jeffrey Nash Individual Corporate OfficerBoard Member Apr 29, 2026

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 5

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": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670544000000",
    "number": "1679690937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 S BRAESWOOD BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770253307",
            "telephone_number": "713-666-2651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 S BRAESWOOD BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770253307",
            "telephone_number": "713-666-2651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAZOS PRESBYTERIAN HOMES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A",
        "authorized_official_last_name": "CALLAHAN",
        "authorized_official_first_name": "SHERYL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "713-660-5012"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TX",
            "license": "117710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bayou Manor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bayou Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.