Active NPI
Somervell County Hospital District
- Rural Acute Care Hospital
- Glen Rose, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rural Acute Care Hospital
- License
- 000059
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200134272 | Other | TX | ALL MANAGED CARE INS |
| HH0458 | Other | TX | BLUE CROSS BLUE SHIELD |
| 121800003 | Medicaid | TX | |
| 121800004 | Medicaid | TX | |
| 200134272 | Other | TX | ALL COMMERCIAL INSURANCE |
Other names 1
- GLEN ROSE MEDICAL CENTER
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Government
- Enrollment address
- 1021 Holden St
Glen Rose, TX 76043-4937 - Hospital subgroups
- General, Acute care, Swing-bed approved, Rehabilitation unit, Specialty hospital
Related certifications (CCN) 1
Facilities connected through Provider of Services related, parent or unit certification numbers.
-
- Rural Acute Care Hospital
- Glen Rose, TX
- NPI 1568574291
Hospital unit
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Rural Acute Care Hospital
- Glen Rose, TX
- NPI 1568574291
7214161090
Care Compare: Hospital
Medicare Care Compare- Listed as
- Glen Rose Medical Center
- Type
- Acute Care Hospitals
- Ownership
- Government - Hospital District or Authority
- Medicare certification status
- Active
- Emergency services
- Yes
National Provider Directory
National Provider Directory- Tax ID family
- Somervell County Hospital District
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Skilled Nursing Facility
- Glen Rose, TX
- NPI 1407190903
-
- Rural Acute Care Hospital
- Glen Rose, TX
- NPI 1568574291
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
- christopherbolton@grmf.medalliesdirect.net
- stephenkrzeminski@grmf.medalliesdirect.net
- aimeeflournoy@grmf.medalliesdirect.net
- michealmoisant@grmf.medalliesdirect.net
- andrewmiller@grmf.medalliesdirect.net
- karenburroughs@grmf.medalliesdirect.net
- stevenvacek@grmf.medalliesdirect.net
- zahidhyder@grmf.medalliesdirect.net
- dalelucus@grmf.medalliesdirect.net
- juliahutchinson@grmf.medalliesdirect.net
- stevenfarzam@grmf.medalliesdirect.net
- josielopez@grmf.medalliesdirect.net
- payalpatel@grmf.medalliesdirect.net
- vinualexander@grmf.medalliesdirect.net
- paulborgfeld@grmf.medalliesdirect.net
- richardadams@grmf.medalliesdirect.net
- kevinmelgren@grmf.medalliesdirect.net
- ziadabdo@grmf.medalliesdirect.net
- kraigpepper@grmf.medalliesdirect.net
- 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Mary Collier | Corporate Officer | Sep 30, 2021 | |
| Ronald Hankins | Corporate Director | May 13, 2014 | |
| Max Bly | Corporate Officer | May 28, 2020 | |
| Michael Honea | Corporate Officer | Mar 22, 2021 | |
| Corporate Director | Jun 17, 2012 | ||
| W-2 Managing Employee | Jun 17, 2012 | ||
| Joe Cathey | Corporate Officer | Jul 29, 2021 | |
| Tra Byers | Corporate Officer | May 25, 2023 | |
| Steven J Vacek | Corporate Officer | May 13, 2016 | |
| Margaret Drake | 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.
| Facility | Type | Role | Since |
|---|---|---|---|
| Glen Rose Nursing and Rehab Center | 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.
-
- Skilled Nursing Facility
- Glen Rose, TX
- NPI 1407190903
5% Or Greater Direct Ownership Interest
Practitioners & affiliated clinicians
Practitioners 29
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Surgery Physician
- Dallas, TX
- NPI 1700838414
-
- Gynecology Physician
- Cleburne, TX
- NPI 1508819509
-
- Podiatrist
- Granbury, TX
- NPI 1790730752
-
- Family Medicine Physician
- Ft Worth, TX
- NPI 1376599209
-
- Internal Medicine Physician
- Fort Worth, TX
- NPI 1356729297
-
- Emergency Medicine Physician
- Fort Worth, TX
- NPI 1881631810
-
- Internal Medicine Physician
- San Angelo, TX
- NPI 1104820976
-
- Family Medicine Physician
- Glen Rose, TX
- NPI 1265437214
-
- Emergency Medicine Physician
- Bluff Dale, TX
- NPI 1629077987
-
- Orthopaedic Surgery Physician
- Stephenville, TX
- NPI 1033188800
-
- Obstetrics & Gynecology Physician
- Cleburne, TX
- NPI 1629074265
-
- Family Medicine Physician
- Glen Rose, TX
- NPI 1811990716
Affiliated clinicians 160
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Advanced Heart Failure and Transplant Cardiology Physician
- Lubbock, TX
- NPI 1629333455
Hospital
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; 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.