Active NPI
Holly Hall
- Nursing Facility/Intermediate Care Facility
- Houston, TX
National Provider Identifier
1760603229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- License
- 000123
- Legal business name
- HOLLY HALL
- Practice address
- 2000 Holly Hall St
Houston, TX 77054-4032 - Phone
- (713) 799-9031
- Fax
- (713) 799-2702
- NPI assigned
- May 1, 2007
- 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
- Mrs. Carol W Klappenbach, RN, BSN
- Title
- Performance Improvement
- Phone
- (713) 799-9033
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 030124 | TX | |
| Nursing Facility/Intermediate Care Facility | 313M00000X | 000123 | TX | Primary |
Addresses
Primary practice location
2000 Holly Hall St
Houston, TX 77054-4032
Mailing address
2000 Holly Hall St
Houston, TX 77054-4032
Phone (713) 799-9031
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001019739 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111209000100 | TX | Part A Provider - Skilled Nursing Facility | 2668647231 | Practice locations: Houston, TX |
Skilled nursing facility certification: CCN 676306
- Legal name
- HOLLY HALL
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Feb 2, 2012
- Last certification
- Aug 29, 2024
- Beds
- 62
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Paradigm Healthcare LLC
- Organization structure
- Corporation
- Enrollment address
- 2000 Holly Hall St
Houston, TX 77054-4032 - Nursing home name
- HOLLY HALL
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Holly Hall
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Feb 2, 2012
- Medicare certification status
- Active
- Certified beds
- 62
National Provider Directory
National Provider Directory- Tax ID family
- Holly Hall
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Member organizations 1
Organizations listed as members of this organization in the National Provider Directory.
Ownership & related parties
All disclosed owners & managing parties 3
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 |
|---|---|---|---|
| Holly Hall | Operational/Managerial Control | Jul 1, 2018 | 100% |
| Peter J Drew | Corporate Officer | Aug 1, 2022 | 100% |
| Operational/Managerial Control | Aug 1, 2022 | ||
| Autumn M Clouse | Corporate Director | Jul 15, 2019 |
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Houston, TX
- NPI 1447664651
Affiliated clinicians 1
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": "1177977600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1437696000000",
"number": "1760603229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 HOLLY HALL ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770544032",
"telephone_number": "713-799-9031",
"fax_number": "713-799-2702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 HOLLY HALL ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770544032",
"telephone_number": "713-799-9031",
"fax_number": "713-799-2702"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOLLY HALL",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-01",
"last_updated": "2015-07-24",
"status": "A",
"authorized_official_last_name": "KLAPPENBACH",
"authorized_official_first_name": "CAROL",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "PERFORMANCE IMPROVEMENT",
"authorized_official_telephone_number": "713-799-9033",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "RN, BSN"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "TX",
"license": "030124",
"primary": false
},
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "TX",
"license": "000123",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001019739",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
- Lisa Robin Holloway, D.O.
- Marcia Kay Holloway, NP-C
- Nancy Alice Holloway, RN WHNPBC
- Shannon Briggs Holloway, PA-C
- Holly Hall (Holly Hall Home Health)
- Holly Health Services, Inc. (Holly Health Services)
- Holly Knudsen Varner, MD PA
- Holly L Huston PHD PA
- Kaila A Holly
- Hollywood Corporation (Hollywood Dental)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; 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.