Organization Active NPI

Somervell County Hospital District

  • Rural Acute Care Hospital
  • Glen Rose, TX
National Provider Identifier
1700826575
Registry record updated Dec 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
License
000059 Issued in TX
Legal business name
SOMERVELL COUNTY HOSPITAL DISTRICT
Practice address
1021 Holden St
Glen Rose, TX 76043-4937
Phone
(254) 897-2215
Fax
(254) 897-1446
NPI assigned
Jun 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2014

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

Authorized official

Name
Earl R Reynolds
Title
C.E.O.
Phone
(254) 897-1425

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X 000059 TX Primary
Durable Medical Equipment & Medical Supplies 332B00000X 000059 TX

Addresses

Primary practice location

1021 Holden St
Glen Rose, TX 76043-4937

Mailing address

1021 Holden St
Glen Rose, TX 76043-4937
Phone (254) 897-2215

Other identifiers 5

IdentifierTypeStateIssuer
200134272OtherTXALL MANAGED CARE INS
HH0458OtherTXBLUE CROSS BLUE SHIELD
121800003MedicaidTX
121800004MedicaidTX
200134272OtherTXALL COMMERCIAL INSURANCE

Other names 1

  • GLEN ROSE 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
O20131010000362 TX Part A Provider - Hospital 7214161090 Practice locations: Glen Rose, TX; Granbury, TX

Hospital certification: CCN 450451

Legal name
SOMERVELL COUNTY HOSPITAL DISTRICT
Doing business as
GLEN ROSE MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 13, 1970
Last certification
Apr 7, 2015
Beds
16
Ownership / control type
Hospital district or authority
Most recent change of ownership
Aug 1, 2013 (5 total)
Organization structure
GovernmentNon-profit
Enrollment address
1021 Holden St
Glen Rose, TX 76043-4937
Other Hospital Practice Location
Hospital subgroups
General, Acute care, Swing-bed approved, Rehabilitation unit, Specialty hospital

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).

Care Compare: Hospital

Medicare Care Compare
Listed as
Glen Rose Medical CenterCCN 450451
Type
Acute Care Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Somervell County Hospital District3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

519 Pine St
Ste 103
Aledo, TX 76008
Phone (817) 441-5500

788 S Watters Rd
Ste 110
Allen, TX 75013
Phone (469) 270-7600

9205 Plantation Dr
Ste 107
Granbury, TX 76049
Phone (817) 573-2755

5305 W University Dr
McKinney, TX 75071
Phone (480) 580-9532

8080 Independence Pkwy
Ste 110
Plano, TX 75025
Phone (469) 658-0100

222 S Collins Rd
Ste 103
Sunnyvale, TX 75182
Phone (214) 256-3778

Interoperability endpoints

  • Direct secure messaging: christopherbolton@grmf.medalliesdirect.net
  • Direct secure messaging: stephenkrzeminski@grmf.medalliesdirect.net
  • Direct secure messaging: aimeeflournoy@grmf.medalliesdirect.net
  • Direct secure messaging: michealmoisant@grmf.medalliesdirect.net
  • Direct secure messaging: andrewmiller@grmf.medalliesdirect.net
  • Direct secure messaging: karenburroughs@grmf.medalliesdirect.net
  • Direct secure messaging: stevenvacek@grmf.medalliesdirect.net
  • Direct secure messaging: zahidhyder@grmf.medalliesdirect.net
  • Direct secure messaging: dalelucus@grmf.medalliesdirect.net
  • Direct secure messaging: juliahutchinson@grmf.medalliesdirect.net
  • Direct secure messaging: stevenfarzam@grmf.medalliesdirect.net
  • Direct secure messaging: josielopez@grmf.medalliesdirect.net
  • Direct secure messaging: payalpatel@grmf.medalliesdirect.net
  • Direct secure messaging: vinualexander@grmf.medalliesdirect.net
  • Direct secure messaging: paulborgfeld@grmf.medalliesdirect.net
  • Direct secure messaging: richardadams@grmf.medalliesdirect.net
  • Direct secure messaging: kevinmelgren@grmf.medalliesdirect.net
  • Direct secure messaging: ziadabdo@grmf.medalliesdirect.net
  • Direct secure messaging: kraigpepper@grmf.medalliesdirect.net
  • Direct secure messaging: jennabates@grmf.medalliesdirect.net

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Mary Collier Individual Corporate Officer Sep 30, 2021
Ronald Hankins Individual Corporate Director May 13, 2014
Max Bly Individual Corporate Officer May 28, 2020
Michael Honea Individual Corporate OfficerCeo Mar 22, 2021
Corporate Director Jun 17, 2012
W-2 Managing Employee Jun 17, 2012
Joe Cathey Individual Corporate Officer Jul 29, 2021
Tra Byers Individual Corporate Officer May 25, 2023
Steven J Vacek Individual Corporate Officer May 13, 2016
Margaret Drake Individual Corporate Officer May 13, 2016

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Glen Rose Nursing and Rehab CenterGlen Rose, TX, CCN 675572 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2021

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 29

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

View all 29

Affiliated clinicians 160

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

View all 160

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419206400000",
    "number": "1700826575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 HOLDEN ST",
            "city": "GLEN ROSE",
            "state": "TX",
            "postal_code": "760434937",
            "telephone_number": "254-897-2215",
            "fax_number": "254-897-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 HOLDEN ST",
            "city": "GLEN ROSE",
            "state": "TX",
            "postal_code": "760434937",
            "telephone_number": "254-897-2215",
            "fax_number": "254-897-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMERVELL COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2014-12-22",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "EARL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "254-897-1425"
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "TX",
            "license": "000059",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "000059",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALL MANAGED CARE INS",
            "identifier": "200134272",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "HH0458",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121800003",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121800004",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALL COMMERCIAL INSURANCE",
            "identifier": "200134272",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GLEN ROSE MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Rose, TX

Sources for this page

Verify at the official NPI Registry.