NPIMap

Organization Active NPI

Anson Hospital District

Doing business as Legacy Nursing and Rehabilitation

  • Skilled Nursing Facility
  • Bryan, TX
National Provider Identifier
1932083235
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ANSON HOSPITAL DISTRICT
Doing business as
Legacy Nursing and Rehabilitation
Practice address
2817 Kent St
Bryan, TX 77802-5214
Phone
(979) 776-7521
NPI assigned
Aug 1, 2025
Last updated
Aug 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Authorized official

Name
Ted Mathews
Title
Ceo
Phone
(325) 823-1152

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

2817 Kent St
Bryan, TX 77802-5214

Mailing address

101 Avenue J
Anson, TX 79501-2113

Other names 1

  • Legacy Nursing and Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260309001660 TX Part A Provider - Skilled Nursing Facility 4880983428

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932083235. Details of each certification follow.

Skilled nursing facility certification: CCN 455351

Legal name
ANSON HOSPITAL DISTRICT
Doing business as
LEGACY NURSING AND REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 7, 1969
Last certification
May 8, 2025
Beds
124 (117 certified)
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Bryan OPCO, LLC
Most recent change of ownership
Sep 1, 2025
Organization structure
GovernmentNon-profit
Enrollment address
2817 Kent St
Bryan, TX 77802-5214
Nursing home name
LEGACY NURSING AND REHABILITATION
Affiliated entity
LEGACY NURSING & REHABILITATION

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Legacy Nursing and RehabilitationCCN 455351 · All quality measures
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Feb 7, 1969
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
117100.2 residents per day on average
Chain
Legacy Nursing & Rehabilitation9 facilities in the chain
Penalties (3 years)
1Fines totaling $12,375

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Anson Hospital District5 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.

Member of 1

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

Ownership & related parties

All disclosed owners & managing parties 23

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

NameRoleSinceShare
Individual Adp of the SNF Sep 1, 2025
Indirect Ownership Interest Sep 1, 2025
Individual Adp of the SNF Sep 1, 2025
Individual Adp of the SNF Sep 1, 2025
Indirect Ownership Interest Sep 1, 2025
Bryan Opco LLC Organization, Baton Rouge, LA LLC Operational/Managerial Control Sep 1, 2025
Adp of the SNF Sep 1, 2025
Victor D Gum Individual Operational/Managerial Control Sep 1, 2025
Adp of the SNF Sep 1, 2025
LP Holdings, LLC Organization, Baton Rouge, LA LLC Adp of the SNF Sep 1, 2025
David T Spraberry Individual Corporate OfficerVice President Sep 1, 2025
Managing Control - Governing BodyVice President Jan 1, 2016
Pete Klein Individual Corporate DirectorBoard Member Sep 1, 2025
Mathew Dymock Individual Operational/Managerial Control Dec 3, 2025
Adp of the SNF Sep 1, 2025
Barbara Vest Individual Corporate OfficerSecretary Sep 1, 2025
Anson Hospital District Organization, Anson, TX 5% Or Greater Direct Ownership Interest Sep 1, 2025
Operational/Managerial Control Sep 1, 2025
Mylesh, LLC Organization, Baton Rouge, LA LLC Adp of the SNF Sep 1, 2025
Max Shaw Individual Corporate DirectorBoard Member Sep 1, 2025
Myles Holyfield Individual Adp of the SNF Sep 1, 2025
Justa Clark Individual Corporate OfficerChief Executive Officer Sep 1, 2025 100%
Managing Control - Governing BodyCeo Sep 1, 2025
Jdgum, LLC Organization, Baton Rouge, LA LLC Adp of the SNF Sep 1, 2025
Larry Lytle Individual Corporate DirectorBoard Member Sep 1, 2025
VDG LLC Organization, Baton Rouge, LA LLC, Owned by another organization or individual Indirect Ownership Interest Sep 1, 2025
Dgprejean, LLC Organization, Baton Rouge, LA LLC Adp of the SNF Sep 1, 2025
Bryan Propco, L.L.C. Organization, Baton Rouge, LA LLC Adp of the SNF Sep 24, 2025
Indirect Ownership Interest Sep 1, 2025
Teri Wilson Individual Corporate DirectorBoard Member Sep 1, 2025
Billie K Haynes Individual Corporate OfficerPresident Sep 1, 2025
Managing Control - Governing BodyBoard President Jan 1, 2016
Diana L Stone Individual Operational/Managerial Control Sep 1, 2025
Adp of the SNF Sep 1, 2025

Owners & managing parties with NPI records 6

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

  • Anson Hospital District
    • Emergency Medicine Physician
    • Anson, TX
    • NPI 1124125521

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Anson Hospital District

    dba Los Arcos del Norte Care Center

    • Skilled Nursing Facility
    • El Paso, TX
    • NPI 1215495965

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Anson Hospital District
    • Rural Acute Care Hospital
    • Anson, TX
    • NPI 1457393571

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Anson Hospital District

    dba Anson Family Wellness Clinic

    • Rural Health Clinic/Center
    • Anson, TX
    • NPI 1891737920

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Bryan Opco LLC

    dba Legacy Nursing and Rehabilitation

    • Skilled Nursing Facility
    • Bryan, TX
    • NPI 1215404330

    Adp of the SNF, Operational/Managerial Control

    CMS ownership
  • Diana L Stone, D.O.
    • Family Medicine Physician
    • Taylor, TX
    • NPI 1649265331

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Anson General HospitalAnson, TX, CCN 670781 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2016
Los Arcos del Norte Care CenterEl Paso, TX, CCN 676283 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2019
Anson Family Wellness ClinicAnson, TX, CCN 673989 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2016

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

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": "1754006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754006400000",
    "number": "1932083235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 AVENUE J",
            "city": "ANSON",
            "state": "TX",
            "postal_code": "795012113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 KENT ST",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025214",
            "telephone_number": "979-776-7521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANSON HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-01",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A",
        "authorized_official_last_name": "MATHEWS",
        "authorized_official_first_name": "TED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "325-823-1152"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Nursing and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.