NPIMap

Organization Active NPI

Haltom Operations, LLC

Doing business as Life Care Center of Haltom

  • Skilled Nursing Facility
  • Fort Worth, TX
National Provider Identifier
1700802873
Registry record updated Jul 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
5090 Issued in TX
Legal business name
HALTOM OPERATIONS, LLC
Doing business as
Life Care Center of Haltom
Practice address
2936 Markum Dr
Fort Worth, TX 76117-4001
Phone
(817) 831-0545
Fax
(817) 831-3051
NPI assigned
Jul 14, 2006
Last updated
Jul 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2026

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

Authorized official

Name
Cindy S Cross
Title
Assistant Secretary
Phone
(423) 473-5867

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 5090 TX Primary

Addresses

Primary practice location

2936 Markum Dr
Fort Worth, TX 76117-4001

Mailing address

3001 Keith St NW
Cleveland, TN 37312-3713
Phone (423) 473-5751

Other identifiers 1

IdentifierTypeStateIssuer
001004029MedicaidTX

Other names 1

  • Life Care Center of Haltom Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070809000487 TX Part A Provider - Skilled Nursing Facility 9335230002 Practice locations: Fort Worth, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700802873. Details of each certification follow.

Skilled nursing facility certification: CCN 675935

Legal name
HALTOM OPERATIONS, LLC
Doing business as
LIFE CARE CENTER OF HALTOM
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Aug 5, 2002
Last certification
Oct 10, 2024
Beds
127
Ownership / control type
Corporation
Multi-facility organization
Life Care Center of America
Organization structure
LLCProprietary
Enrollment address
2936 Markum Dr
Fort Worth, TX 76117-4001
Nursing home name
LIFE CARE CENTER OF HALTOM
Affiliated entity
LIFE CARE CENTERS OF AMERICA

Care Compare: Nursing home

Medicare Care Compare
Listed as
Life Care Center of HaltomCCN 675935 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Aug 5, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
127100.7 residents per day on average
Chain
Life Care Centers of America194 facilities in the chain
Penalties (3 years)
1Fines totaling $22,205

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
45D1040044Life Care Center of Haltom2936 Markum Drive, Fort Worth, TX 76117Certificate of waiverApr 27, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Julie Laree Wyatt Individual Operational/Managerial Control Jan 2, 2025
Managing Control - Governing BodyDirector of Nursing Jan 2, 2025
Forrest L Preston Individual 5% Or Greater Direct Ownership InterestMember Feb 16, 2007 99%
Corporate OfficerChairman/Ceo of Management Co. Aug 1, 2007
Adp of the SNF Jun 30, 2002
Direct Ownership Interest Feb 16, 2007 99%
Indirect Ownership Interest Feb 16, 2007 1%
Terry Henry Individual Corporate OfficerAsst Treasurer of Management Co. Aug 16, 1999
Todd Fletcher Individual Operational/Managerial Control Dec 13, 2024
Aubrey Preston Individual Operational/Managerial Control Dec 13, 2024
Joan E Thurmond Individual Corporate OfficerAsst Secretary of Management Co. Sep 22, 2000
Nancy Butner Individual Operational/Managerial Control Sep 16, 2018
Managing Control - Governing BodyDivisional Vice President Sep 16, 2018
Cindy S Cross Individual Corporate OfficerVP/Asst Secretary of Management Co. Aug 1, 2007
Joseph Berck Individual Operational/Managerial Control Dec 1, 2022
Managing Control - Governing BodyAdministrator Dec 1, 2022
Adp of the SNF Mar 3, 2025
Organization, Cleveland, TN LLC, For-profit Adp of the SNF Jun 30, 2002
Richard Swanker Individual Corporate OfficerChief Tax Officer of Management Co. Apr 1, 2011
Life Care Centers of America, Inc. Organization, Cleveland, TN Corporation, Management services company, For-profit, Chain home office Operational/Managerial Control Aug 1, 2007 100%
Adp of the SNF Mar 3, 2025
Soroush Behnam Individual Operational/Managerial Control May 1, 2017
Adp of the SNF Mar 3, 2025
Lisa M Lay Individual Corporate OfficerSecretary of Management Company Feb 9, 2018
James Ziegler Individual Operational/Managerial Control Dec 13, 2024
Developers Investment Company II, Inc Organization, Cleveland, TN Corporation, For-profit Operational/Managerial Control Feb 16, 2007
Direct Ownership Interest Feb 16, 2007 1%

Owners & managing parties with NPI records 26

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

View all 26

Facilities with the same owner 193

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

View all 193

Practitioners & affiliated clinicians

Practitioners 2

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.

Affiliated clinicians 2

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": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783814400000",
    "number": "1700802873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 KEITH ST NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123713",
            "telephone_number": "423-473-5751",
            "fax_number": "423-339-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2936 MARKUM DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761174001",
            "telephone_number": "817-831-0545",
            "fax_number": "817-831-3051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALTOM OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2026-07-12",
        "certification_date": "2026-07-12",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "423-473-5867"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "5090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001004029",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "284 Merchant St",
            "city": "Ste Genevieve",
            "state": "MO",
            "country_code": "US",
            "postal_code": "636701610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Life Care Center of Haltom",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.