NPIMap

Organization Active NPI

Baylor Scott & White Medical Center - Centennial

  • General Acute Care Hospital
  • Frisco, TX
National Provider Identifier
1801826839
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
100421 Issued in TX
Legal business name
BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL
Practice address
12505 Lebanon Rd
Frisco, TX 75035
Phone
(972) 963-3333
NPI assigned
Jul 4, 2006
Last updated
Aug 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Authorized official

Name
Jacob Ryan Gebhart
Title
Ceo
Phone
(469) 814-4801

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X
General Acute Care Hospital 282N00000X 100421 TX Primary

Addresses

Primary practice location

12505 Lebanon Rd
Frisco, TX 75035

Mailing address

PO Box 840782
Dallas, TX 75284-0782

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180316001114 TX Part A Provider - Hospital 2062774771 Practice locations: Frisco, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801826839. Details of each certification follow.

Hospital certification: CCN 450885

Legal name
BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jun 16, 2004
Last certification
Nov 6, 2025
Beds
118
Ownership / control type
Private (not for profit)
Most recent change of ownership
Mar 1, 2018 (2 total)
Organization structure
OtherNon-profit
Incorporated
Jan 10, 2018 in TX
Enrollment address
12505 Lebanon Rd
Frisco, TX 75035-8298
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
Baylor Scott & White Medical Center - CentennialCCN 450885 · All quality measures
Overall star rating
5 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1023629Baylor Scott & White Medical Center-Centennial12505 Lebanon Rd, Frisco, TX 75035AccreditationMay 11, 2027

National Provider Directory

National Provider Directory
Tax ID family
Baylor Scott White Medical Center - Centennial2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 27

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

NameRoleSinceShare
Justin Meier Individual OtherSVP Corporate Finance Feb 9, 2023
Pamela Linton Individual Corporate DirectorTrustee Jul 1, 2024
Baylor Health Care System Organization, Dallas, TX Corporation, Non-profit Operational/Managerial Control Mar 1, 2018
Cody Sedlacek Individual OtherDirector, Supply Chain Operations Feb 8, 2024
Dawn Snyder Individual OtherPac/Ris Administrator Feb 8, 2024
Baylor Scott & White Medical Center - Centennial Organization, Frisco, TX Corporation, Non-profit Operational/Managerial Control Mar 1, 2018
Rachel Vannoy Individual OtherDirector of Nursing Feb 8, 2024
Baylor Scott & White Health Organization, Temple, TX Corporation, Non-profit Operational/Managerial Control Mar 1, 2018
Michelle Stukey Individual OtherDirector, Him Operations Feb 8, 2024
Rodrick Robinson Individual Corporate DirectorTrustee Oct 1, 2020
Marissa Yarid Hernandez Individual Corporate DirectorTrustee Mar 26, 2021
April C Barbee-Baker Individual OtherDirector Quality Improvement Feb 8, 2024
Timothy L Owens Individual Corporate DirectorTrustee Jul 1, 2024
Sujatha Krishnan Individual OtherMedical Director Feb 8, 2024
Heather J Carlisle Individual OtherDirector Surgical Services Feb 8, 2024
Eric D Beshires Individual OtherVP Medical Affairs Feb 8, 2024
Meagan James Individual OtherDirector Nursing Feb 8, 2024
Jeff Schmeltekopf Individual Corporate DirectorTrustee Mar 1, 2018
Amy J Wilson Individual Corporate DirectorTrustee Mar 31, 2023
Harry Dugger Individual Corporate DirectorTrustee Jul 1, 2019
Nolan D Rich Individual W-2 Managing Employee May 12, 2026
Operational/Managerial ControlCfo May 12, 2026
Brenda Helms Individual OtherRegional Director for Clinical Comp Feb 8, 2024
Christin Timmons Individual OtherVP Cno - Centennial Feb 8, 2024
Paul D Meggs Individual OtherMedical Director Feb 8, 2024
Wesley Tidwell Individual W-2 Managing EmployeeCeo Feb 17, 2025
Operational/Managerial ControlCeo Feb 17, 2025
Leslie Wiebe Individual OtherDirector of Hospital Operations Feb 8, 2024
Lisa Hultz Individual Corporate DirectorTrustee Jul 1, 2022

Owners & managing parties with NPI records 4

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

Facilities with the same owner 44

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

View all 44

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

Affiliated clinicians 293

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

View all 293

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722470400000",
    "number": "1801826839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840782",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12505 LEBANON RD",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75035",
            "telephone_number": "972-963-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A",
        "authorized_official_last_name": "GEBHART",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "469-814-4801"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TX",
            "license": "100421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.