NPIMap

Organization Active NPI

Scott & White Memorial Hospital

Doing business as Baylor Scott & White Dialysis Center - Killeen

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Killeen, TX
National Provider Identifier
1922063320
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
007218 Issued in TX
Legal business name
SCOTT & WHITE MEMORIAL HOSPITAL
Doing business as
Baylor Scott & White Dialysis Center - Killeen
Practice address
3701 Scott and White Dr
Killeen, TX 76543-5228
Phone
(254) 680-1371
NPI assigned
Apr 19, 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
Christopher L Olsen
Title
Cfo
Phone
(254) 724-4556

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 007218 TX Primary

Addresses

Primary practice location

3701 Scott and White Dr
Killeen, TX 76543-5228

Mailing address

PO Box 847790
Dallas, TX 75284-7790
Phone (254) 215-9522

Other identifiers 2

IdentifierTypeStateIssuer
1127375-03MedicaidTX
HH6327OtherTXBLUE CROSS

Other names 1

  • Baylor Scott & White Dialysis Center - Killeen Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120222001040 TX Part A Provider - End-Stage Renal Disease Facility (ESRD) 8123076015 Practice locations: Killeen, TX

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Scott and White Hospital16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Member organizations 12

Organizations listed as members of this organization in the National Provider Directory.

Locations

3701 Scott and White Dr
Killeen, TX 76543
Phone (254) 680-1371

3701 Scott White Dr
Temple, TX 76508

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Baylor Scott & White Medical Center HillcrestWaco, TX, CCN 45T101 Hospital Operational/Managerial Control Jan 1, 2025
Adventhealth Central TexasKilleen, TX, CCN 450152 Hospital 5% Or Greater Direct Ownership Interest (32%) Jul 1, 2008
Adventhealth Rollins BrookLampasas, TX, CCN 451323 Hospital 5% Or Greater Direct Ownership Interest (32%) Jul 1, 2008
Adventhealth Rollins Brook Swing Bed Skilled Nursing FacilityLampasas, TX, CCN 45Z323 Hospital 5% Or Greater Direct Ownership Interest (32%) Jul 1, 2008
Adventhealth Family Medicine Clinic Copperas CoveCopperas Cove, TX, CCN 673920 Rural health clinic 5% Or Greater Direct Ownership Interest (32%) Jul 1, 2008
Adventhealth Family Medicine Clinic LampasasLampasas, TX, CCN 458905 Rural health clinic 5% Or Greater Direct Ownership Interest (32%) Jul 1, 2008

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722470400000",
    "number": "1922063320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847790",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847790",
            "telephone_number": "254-215-9522",
            "fax_number": "254-215-9524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 SCOTT AND WHITE DR",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765435228",
            "telephone_number": "254-680-1371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT & WHITE MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A",
        "authorized_official_last_name": "OLSEN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "254-724-4556"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "TX",
            "license": "007218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1127375-03",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "HH6327",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baylor Scott & White Dialysis Center - Killeen",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Killeen, TX

Sources for this page

Verify at the official NPI Registry.