Incarnate Word Retirement Community, Inc.

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

000204 Issued in TX

Legal business name

INCARNATE WORD RETIREMENT COMMUNITY, INC.

Doing business as

The Village at Incarnate Word

Practice address

4707 Broadway
San Antonio, TX 78209-6215

Phone

(210) 829-7561

Fax

(210) 829-1601

NPI assigned

May 31, 2007

Organization subpart

No

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

Authorized official

Name

Le Roy Fields Campbell

Title

Chief Executive Officer

Phone

(210) 829-7561

Specialties & licenses 4

Addresses

Other names 1

• The Village at Incarnate Word Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Skilled nursing facility certification: CCN 676498

Legal name

INCARNATE WORD RETIREMENT COMMUNITY, INC.

Doing business as

THE VILLAGE AT INCARNATE WORD

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF distinct part

Participating since

Jun 3, 2021

Last certification

Sep 27, 2024

Beds

60

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Apr 7, 1989 in TX

Enrollment address

4707 Broadway
San Antonio, TX 78209-6215

Nursing home name

THE VILLAGE AT INCARNATE WORD

Listed as

The Village at Incarnate WordCCN 676498 · All quality measures

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

4 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Jun 3, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6056.8 residents per day on average

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 10

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

Owners & managing parties with NPI records 3

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

• Carvajal Pharmacy LTC

  dba Carvajal Pharmacy LTC LLC

  • Long Term Care Pharmacy
  • San Antonio, TX
  • NPI 1265549638

  Adp of the SNF

  CMS ownership
• Rudolfo Pedraza Zarate Jr., M.D.

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1770589384

  Adp of the SNF

  CMS ownership
• Select Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Glenview, IL
  • NPI 1346368248

  Adp of the SNF

  CMS ownership

Practitioners 2

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

• Lynda Jennings, OTR

  • Occupational Therapist
  • San Antonio, TX
  • NPI 1588817134
  NPD
• Angelica Esquivel Davila, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • San Antonio, TX
  • NPI 1366703720
  NPD (past)

Affiliated clinicians 2

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

• Angelica Esquivel Davila, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • San Antonio, TX
  • NPI 1366703720

  Nursing home

  Care Compare affiliation
• Rudolfo Pedraza Zarate Jr., M.D.

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1770589384

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781568000000",
    "number": "1720289036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4707 BROADWAY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782096215",
            "telephone_number": "210-829-7561",
            "fax_number": "210-829-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4707 BROADWAY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782096215",
            "telephone_number": "210-829-7561",
            "fax_number": "210-829-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INCARNATE WORD RETIREMENT COMMUNITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A",
        "authorized_official_last_name": "FIELDS CAMPBELL",
        "authorized_official_first_name": "LE ROY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "210-829-7561"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TX",
            "license": "000204",
            "primary": true
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Village at Incarnate Word",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Village at Incarnate Word",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Koree Lorraine Ince, BCBA
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• Nursing Facility/Intermediate Care Facility in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Nursing Facility/Intermediate Care Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2026; 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.

Verify at the official NPI Registry.