Active NPI
Brazos Presbyterian Homes Inc.
- Nursing Facility/Intermediate Care Facility
- Houston, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- License
- 117710
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Corporation
- 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 Manor
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare
- Ownership
- Non profit - Corporation
- Certified
- May 18, 2011
- Medicare certification status
- Active
- Certified beds
- 37
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D0961805 | Bayou Manor | Certificate of waiver | Jun 16, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Bayou Manor
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Skilled Nursing Facility
- Houston, TX
- NPI 1376754028
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Jeanette Wennenweser | Corporate Director | Jan 1, 2015 | |
| John Lemen | Corporate Director | Jan 1, 2017 | |
| Sharon Darden | Corporate Director | Jan 1, 2022 | |
| Judy Lakin | Corporate Director | Jan 1, 2026 | |
| David Elledge | Corporate Officer | Jan 1, 2025 | |
| Michael Cummings | Operational/Managerial Control | Dec 15, 2025 | |
| Adp of the SNF | Feb 2, 2026 | ||
| Richard Leathers | Corporate Director | Jan 1, 2013 | |
| Andy Gans | Corporate Director | Jan 1, 2018 | |
| Locke Braly | Corporate Officer | Jan 1, 2025 | |
| John Hudson | Corporate Director | Jan 1, 2021 | |
| John Hartman | Corporate Director | Jan 1, 2018 | |
| Kathleen Redden | Corporate Director | Jan 1, 2011 | |
| Suzanne McPhail | Corporate Director | Jan 1, 2018 | |
| Deidre Kinsey | Corporate Officer | Sep 1, 2024 | |
| Operational/Managerial Control | Sep 1, 2024 | ||
| Richard Nunn | Corporate Officer | Jan 1, 2015 | |
| Roberto Camacho-Acevedo | Adp of the SNF | Feb 26, 2024 | |
| Jeffrey Nash | Corporate Officer | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.