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Organization Active NPI

Methodist Hospitals of Dallas

  • General Acute Care Hospital
  • Mansfield, TX
National Provider Identifier
1689629941
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
METHODIST HOSPITALS OF DALLAS
Practice address
2700 E Broad St
Mansfield, TX 76063-5899
Phone
(682) 622-2000
NPI assigned
May 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Authorized official

Name
Craig Allen Bjerke
Title
Executive VP & Cfo
Phone
(214) 947-4512

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

2700 E Broad St
Mansfield, TX 76063-5899

Mailing address

PO Box 911875
Dallas, TX 75391-1875
Phone (682) 242-2000

Other identifiers 2

IdentifierTypeStateIssuer
186221102OtherTXMEDICAID HASCO NUMBER
186221101MedicaidTX

Other names 1

  • Methodist Mansfield Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061018000050 TX Part A Provider - Hospital 5294646451 Practice locations: Arlington, TX; Mansfield, TX

Hospital certification: CCN 670023

Legal name
METHODIST HOSPITALS OF DALLAS
Doing business as
METHODIST MANSFIELD MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Feb 5, 2007
Last certification
Aug 29, 2025
Beds
294 (196 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Apr 18, 1935 in TX
Enrollment address
2700 E Broad St
Mansfield, TX 76063-5899
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs with the same Medicare PAC ID 7

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Methodist Mansfield Medical CenterCCN 670023
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Charlton Methodist ER10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Ownership & related parties

All disclosed owners & managing parties 39

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

NameRoleSinceShare
Amy Bodwell Individual Corporate DirectorSr VP of Finance Aug 29, 2011
Samir K Nangia Individual Corporate DirectorBoard Member Oct 1, 2024
Rex Glendenning Individual Corporate DirectorBoard Member Sep 24, 2024
John Oliphint Individual Corporate DirectorBoard Member Mar 23, 2021
John Patrick Faubion Individual Corporate DirectorDirector Nov 22, 2016
Larry Michael McKee Individual Corporate Director Jun 27, 2017
Daniel Johnson Individual Corporate DirectorBoard Member Mar 26, 2024
Keith Payne Boone Individual Corporate DirectorDirector Nov 22, 2016
Marcus Knight Individual Corporate DirectorBoard Member Mar 24, 2020
Martin Leroy Koonsman Individual Corporate OfficerChief Medical Officer Nov 27, 2012
Julie Yarbrough Individual Corporate Director Jun 23, 2009
David R McAtee Individual Corporate Director Mar 26, 2013
Armin Mizani Individual Corporate DirectorBoard Member Feb 28, 2023
Carol B Norton Individual Corporate DirectorBoard Member Mar 28, 2023
Jamie Wickliffe Individual Corporate DirectorBoard Member Mar 26, 2024
Brenda L Jackson Individual Corporate Director Sep 23, 2004
Bernard P Difiore Individual Corporate DirectorDirector Mar 22, 2016
Levi H Davis Individual Corporate Director Oct 18, 2006
Juan Fresquez Individual W-2 Managing EmployeePresident MMMC Feb 25, 2019
Pamela Stoyanoff Individual Corporate OfficerChief Operating Officer/President Mar 1, 2007
Ruben L Velez Individual Corporate Director Oct 18, 2006
Delia Jasso Individual Corporate DirectorBoard Member Mar 28, 2023
Methodist Hospitals of Dallas Organization, Dallas, TX Chain home office 5% Or Greater Direct Ownership Interest Dec 1, 2006
Operational/Managerial Control Dec 1, 2006
Donald Williams Individual Corporate DirectorBoard Member Jul 25, 2023
John R Candey Individual Corporate Director Jan 27, 2009
Gerald Bright Individual Corporate DirectorBoard Member Mar 27, 2018
Yon Jorden Individual Corporate DirectorBoard Member Mar 28, 2023
Robert S Folsom Individual Corporate Director Apr 21, 2008
Michael O Price Individual Corporate OfficerChief Legal Officer - MHS Dec 7, 2000
Mae Helen Giddings Individual Corporate DirectorBoard Member Mar 24, 2020
Michael L Finch Individual Corporate DirectorBoard Member Mar 24, 2020
Kenneth Govan Individual Corporate DirectorBoard Member Mar 23, 2021
Ruben Saenz, Jr. Individual Corporate DirectorBoard Member Mar 28, 2023
Joseph B Fortson Individual Corporate Director Oct 18, 2006
Timothy Griffy Individual Corporate DirectorBoard Member Mar 24, 2020
Duncan T Fulton Individual Corporate Director Apr 20, 2010
Craig Bjerke Individual Corporate OfficerChief Financial Officer - MHS Oct 1, 2018
W-2 Managing Employee Oct 17, 2016
Alan Walne Individual Corporate DirectorBoard Member Mar 28, 2023
James C Scoggin Individual Corporate OfficerChief Executive Officer - MHS Apr 22, 2019
Corporate DirectorBoard Member Apr 22, 2019
W-2 Managing EmployeeCeo-MHS Apr 22, 2019

Owners & managing parties with NPI records 12

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

All facility ownership & control disclosures 11

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Methodist Dallas Medical CenterDallas, TX, CCN 450051 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jul 1, 1984
Jul 1, 1984
Methodist Charlton Medical CenterDallas, TX, CCN 450723 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jul 1, 1984
Jul 1, 1984
Methodist Rehabilitation HospitalDallas, TX, CCN 673031 Hospital 5% Or Greater Direct Ownership Interest (68.25%) Jan 21, 2008
Methodist McKinney HospitalMcKinney, TX, CCN 670069 Hospital 5% Or Greater Direct Ownership Interest (46.5%) Jul 1, 2023
Methodist Hospital for SurgeryAddison, TX, CCN 670073 Hospital 5% Or Greater Indirect Ownership Interest (41%) Jul 1, 2023
Methodist Richardson Medical CenterRichardson, TX, CCN 450537 Hospital Operational/Managerial Control Oct 1, 2011
Methodist Richardson Medical CenterRichardson, TX, CCN 45S537 Hospital Operational/Managerial Control Oct 1, 2011
Methodist Midlothian Medical CenterMidlothian, TX, CCN 670300 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Sep 10, 2018
Sep 10, 2018
Methodist Southlake Medical CenterSouthlake, TX, CCN 670132 Hospital 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2021
Methodist Celina Medical CenterCelina, TX, CCN 670340 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jul 26, 2024
Jul 26, 2024
Forvis Mazars, LLPDesoto, TX, CCN 676492 Skilled nursing facility 5% Or Greater Direct Ownership Interest (51%)
Operational/Managerial Control
Adp of the SNF		 Nov 1, 2019
Apr 1, 2018
Mar 15, 2020

Owned or controlled facilities with NPI records 11

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 11

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

Practitioners & affiliated clinicians

Practitioners 52

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 52

Affiliated clinicians 504

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

View all 504

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1689629941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911875",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753911875",
            "telephone_number": "682-242-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 E BROAD ST",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635899",
            "telephone_number": "682-622-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST HOSPITALS OF DALLAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "BJERKE",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "EXECUTIVE VP & CFO",
        "authorized_official_telephone_number": "214-947-4512"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID HASCO NUMBER",
            "identifier": "186221102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186221101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Methodist Mansfield Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Methodist Mansfield Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.