Active NPI
MRC Cornerstone
- Skilled Nursing Facility
- Texarkana, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- MRC CORNERSTONE
- Practice address
- 4100 Moores LN
Texarkana, TX 75503-5102 - Phone
- (903) 831-2968
- Fax
- (903) 832-5553
- NPI assigned
- Jul 21, 2005
- 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
- Mr. Don Stephens
- Title
- Treasurer/Cfo
- Phone
- (281) 210-0138
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 113743 | TX | |
| Skilled Nursing Facility | 314000000X | 113743 | TX | |
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
4100 Moores LN
Texarkana, TX 75503-5102
Mailing address
1440 Lake Front Circle Suite 140
The Woodlands, TX 77380
Phone (281) 210-0138
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001025701 | Medicaid | TX |
Other names 1
- Cornerstone Retirement Community
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130529000864 | TX | Part A Provider - Skilled Nursing Facility | 8628216819 | Practice locations: Texarkana, TX |
Skilled nursing facility certification: CCN 676359
- Legal name
- MRC CORNERSTONE
- Doing business as
- CORNERSTONE RETIREMENT COMMUNITY
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Apr 23, 2014
- Last certification
- Nov 6, 2024
- Beds
- 40
- Ownership / control type
- Nonprofit Corporation
- Multi-facility organization
- Methodist Retirement Community
- Organization structure
- Corporation
- Incorporated
- Aug 4, 1994 in TX
- Enrollment address
- 4100 Moores LN
Cornerstone Retirement Community
Texarkana, TX 75503-5102 - Nursing home name
- CORNERSTONE RETIREMENT COMMUNITY
- Affiliated entity
- METHODIST RETIREMENT COMMUNITIES
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Cornerstone Retirement Community
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Apr 23, 2014
- Medicare certification status
- Active
- Certified beds
- 40
- Chain
- Methodist Retirement Communities
- Penalties (3 years)
- 1
National Provider Directory
National Provider Directory- Tax ID family
- Cornerstone Retirement Community
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Skilled Nursing Facility
- Bryan, TX
- NPI 1578563342
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Adp of the SNF | Mar 1, 2024 | ||
| Alicia Besser | Corporate Director | Jul 1, 2024 | |
| Kip Gilts | Corporate Director | Jul 1, 2020 | |
| Donald Stephens | Corporate Officer | Jan 7, 2015 | |
| Walter Woodward | Corporate Director | Jul 1, 2024 | |
| Truist Bank | 5% Or Greater Mortgage Interest | Dec 6, 2019 | |
| Richard Morgan | Corporate Director | Jul 1, 2017 | |
| Romonica Malone-Wardley | Corporate Director | Jul 1, 2023 | |
| William King | Corporate Director | Jan 1, 2018 | |
| Alan Dwight Brown | Corporate Officer | Apr 13, 2020 | |
| Corporate Director | Apr 13, 2020 | ||
| Amy Thomas | Operational/Managerial Control | Apr 1, 2018 | |
| Billy Williamson | Corporate Director | Jul 1, 2010 | |
| Adp of the SNF | Jul 31, 2025 | ||
| Dale D Conger | Corporate Director | Feb 21, 2020 | |
| Ed Simmons | Corporate Director | Feb 10, 2023 | |
| Adp of the SNF | Jul 31, 2025 | ||
| James S Bunch | Corporate Director | Aug 13, 2020 | |
| Matthew Currie | Corporate Officer | Aug 21, 2025 | |
| Alyce Baggett | Corporate Director | Jul 1, 2013 | |
| Sydney Elmore | Operational/Managerial Control | Apr 1, 2024 | |
| Adp of the SNF | Apr 1, 2024 | ||
| Adp of the SNF | Aug 29, 2025 | ||
| William a Koerner | Corporate Director | Feb 21, 2020 | |
| MRC Cornerstone | 5% Or Greater Direct Ownership Interest | Apr 23, 2014 | 100% |
| The Aldersgate Trust | 5% Or Greater Indirect Ownership Interest | Jun 11, 2010 | 100% |
| Adp of the SNF | Jun 11, 2010 | ||
| Charles Lewis | Operational/Managerial Control | Mar 18, 2024 | |
| Todd K. Partin | Operational/Managerial Control | Feb 28, 2013 | |
| Frankie F Watson | Corporate Director | Nov 12, 2021 |
Facilities with the same owner 4
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Corpus Christi, TX
- NPI 1467914242
The Aldersgate Trust
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.
-
- Home Health Agency
- Texarkana, TX
- NPI 1245230812
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Nashville, AR
- NPI 1518962968
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": "1121904000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1589155200000",
"number": "1942200852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1440 LAKE FRONT CIRCLE SUITE 140",
"city": "THE WOODLANDS",
"state": "TX",
"postal_code": "77380",
"telephone_number": "281-210-0138",
"fax_number": "281-292-6360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 MOORES LN",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755035102",
"telephone_number": "903-831-2968",
"fax_number": "903-832-5553"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MRC CORNERSTONE",
"organizational_subpart": "NO",
"enumeration_date": "2005-07-21",
"last_updated": "2020-05-11",
"certification_date": "2020-05-11",
"status": "A",
"authorized_official_last_name": "STEPHENS",
"authorized_official_first_name": "DON",
"authorized_official_title_or_position": "TREASURER/CFO",
"authorized_official_telephone_number": "281-210-0138",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "TX",
"license": "113743",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "TX",
"license": "113743",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001025701",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Cornerstone Retirement Community",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Cornerstone Retirement Community",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Texarkana, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; 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.