NPIMap

Organization Active NPI

Scott & White Hospital - Taylor

Doing business as Baylor Scott & White Medical Center - Taylor

  • Medicare Defined Swing Bed Hospital Unit
  • Taylor, TX
National Provider Identifier
1710094446
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
SCOTT & WHITE HOSPITAL - TAYLOR
Doing business as
Baylor Scott & White Medical Center - Taylor
Practice address
305 Mallard LN
Taylor, TX 76574-1208
Phone
(512) 352-7611
Fax
(512) 352-4734
NPI assigned
Aug 25, 2006
Last updated
Aug 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Authorized official

Name
Jay Fox
Title
Ceo
Phone
(512) 509-0409

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary
Critical Access Hospital 282NC0060X 44 TX

Addresses

Primary practice location

305 Mallard LN
Taylor, TX 76574-1208

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (512) 352-7611

Other names 1

  • Baylor Scott & White Medical Center - Taylor Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091111000732 TX Part A Provider - Critical Access Hospital 1456246750 Practice locations: Taylor, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1710094446. Details of each certification follow.

Hospital certification: CCN 45Z374

Legal name
SCOTT & WHITE HOSPITAL - TAYLOR
Doing business as
BAYLOR SCOTT & WHITE MEDICAL CENTER TAYLOR
Organization structure
CorporationNon-profit
Incorporated
Oct 20, 1967 in TX
Enrollment address
305 Mallard LN
Taylor, TX 76574-1208
Other Hospital Practice Location

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).

National Provider Directory

National Provider Directory
Tax ID family
Scott White Hospital Taylo5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 24

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

NameRoleSinceShare
William Rogers Individual Operational/Managerial ControlTrustee Jul 1, 2015
Justin Meier Individual Operational/Managerial ControlSVP Corporate Finance Feb 9, 2023
Mark L Montgomery Individual Operational/Managerial ControlTrustee Jul 1, 2015
Morris E Foster Individual Operational/Managerial ControlTrustee Jul 1, 2015
Mark W English Individual Operational/Managerial ControlTrustee Jul 1, 2022
Tresa Muir McNeal Individual Operational/Managerial ControlTrustee Nov 30, 2017
Scott & White Healthcare Organization, Temple, TX Non-profit Operational/Managerial Control Sep 1, 2010
Thomas Burdett Individual Operational/Managerial ControlTrustee Jul 1, 2015
Terry Maness Individual Operational/Managerial ControlTrustee Feb 23, 2019
Baylor Scott & White Health Organization, Temple, TX Non-profit Operational/Managerial Control Mar 1, 2014
Dominic Lucia Individual Operational/Managerial ControlTrustee Dec 4, 2020
William D Digaetano Individual Operational/Managerial ControlTrustee Jul 1, 2019
Muralidhar Jatla Individual Operational/Managerial ControlTrustee Jul 1, 2023
Jim Kruse Individual Operational/Managerial ControlTrustee Jul 1, 2015
Nelda Trevino Individual Operational/Managerial ControlTrustee Dec 4, 2020
Jason Cole Individual Corporate DirectorCfo Jul 30, 2007
W-2 Managing EmployeeCfo Jul 30, 2007
Operational/Managerial ControlCfo Jul 30, 2007
Donald R Grobowsky Individual Operational/Managerial ControlTrustee Jul 1, 2015
Aval-NA'Ree S Green Individual Operational/Managerial ControlTrustee Jul 1, 2023
Robert D McLane Individual Operational/Managerial ControlTrustee Jul 1, 2015
Angel Eduardo Caldera Individual Operational/Managerial ControlTrustee Nov 30, 2017
Arundhati Rao Individual Operational/Managerial ControlTrustee Dec 4, 2020
Andra Liemandt Individual Operational/Managerial ControlTrustee Jul 1, 2023
Jarvis Parsons Individual Operational/Managerial ControlTrustee Jul 1, 2024
Jay Fox Individual Corporate DirectorCeo Oct 1, 2014
W-2 Managing EmployeeCeo Oct 1, 2014
Operational/Managerial ControlCeo Oct 1, 2014

Owners & managing parties with NPI records 8

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

Facilities with the same owner 36

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

View all 36

Practitioners & affiliated clinicians

Practitioners 5

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": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690848000000",
    "number": "1710094446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "512-352-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MALLARD LN",
            "city": "TAYLOR",
            "state": "TX",
            "postal_code": "765741208",
            "telephone_number": "512-352-7611",
            "fax_number": "512-352-4734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT & WHITE HOSPITAL - TAYLOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-509-0409"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "TX",
            "license": "44",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baylor Scott & White Medical Center - Taylor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Baylor Scott & White Medical Center - Taylor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Taylor, TX

Sources for this page

Verify at the official NPI Registry.