The Community Hospital of Brazosport
Organization Active NPI General Acute Care Hospital · Lake Jackson, TX
NPI 1972581940 · NPPES record last updated Mar 13, 2024
Key facts
- NPI
- 1972581940
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- License
- 000436 (TX)
- Legal business name
- THE COMMUNITY HOSPITAL OF BRAZOSPORT
- Practice address
- 100 Medical Dr
Lake Jackson, TX 77566 - Phone
- (979) 297-4411
- Fax
- (979) 285-1730
- NPI assigned
- Jan 9, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Robert Trautman
- Title
- President
- Phone
- (979) 285-1802
Owners & managing parties with NPI records 1
-
Michael W Steines, MD, FACS
Subparts reporting this organization as parent 2
Member organizations 3
Facilities with the same owner 18
Practitioners 12
-
Lyndon F Barnwell, M.D.
-
Prince Buzombo, MD
-
Izuchukwu C Iwueke, M.D.
-
Mohammad Afzal Khan, M.D.
-
Raymond Michael Nieto, M.D.
-
Azfar Syed, MD
-
Elisa M. Foster, DO
-
Il-Ran Hwang, M.D
Affiliated clinicians 158
-
Fabio G Aglieco, DO
-
Mahboob Alam, M.D.
-
Nehme Alkarra, MD
-
Manaf A Alroumoh, M.D.
-
Haider Salam Alwash, M.D.
-
Alkesh C Amin, MD
-
Naveed Shahid Anwar, M.D.
-
Basant Arya, M.D
-
Austin Atkins, PA-C
-
Lee Attema, FNP/ENP
-
Divyang C Ayar, MD
-
Mustanser Mahmood Badar, MD, MPH, RPVI
-
Lyndon F Barnwell, M.D.
-
Lawrence Owen Baum III, M.D.
-
Cecilia Nicole Bell, FNP
-
Augnes Binu, FNP-C, ACNPC-AG
-
Yochai Birnbaum, MD
Medicare Care Compare: Hospital
- Listed as
- CHI St Luke'S Health Brazosport
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare Care Compare: Inpatient rehabilitation facility
- Listed as
- Brazosport Memorial Hospital
- Ownership
- Non-profit
- Certified
- Jan 1, 1996
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D0497104 | CHI St Luke'S Health Brazosport Lab | Accreditation | Feb 8, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX
Hospital certification: CCN 450072
- Legal name
- THE COMMUNITY HOSPITAL OF BRAZOSPORT
- Doing business as
- CHI ST LUKE'S HEALTH BRAZOSPORT
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Mar 13, 2025
- Beds
- 165
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Mar 13, 1961 in TX
- Enrollment address
- 100 Medical Dr
Lake Jackson, TX 77566-5674 - Hospital subgroups
- General, Acute care
Hospital certification: CCN 45T072
- Legal name
- THE COMMUNITY HOSPITAL OF BRAZOSPORT
- Doing business as
- CHI ST. LUKE'S HEALTH BRAZOSPORT
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 100 Medical Dr
Lake Jackson, TX 77566-5674 - Hospital subgroups
- Acute care, Rehabilitation unit
All disclosed owners & managing parties 22
| Name | Role | Since | Share |
|---|---|---|---|
| Doug Lawson |
Corporate Officer |
Jul 1, 2021 | |
| Corporate Director |
Jul 1, 2021 | ||
| Michael Steines |
Corporate Director |
Mar 26, 2024 | |
| Gary Whitlock |
Corporate Director |
Jul 1, 2021 | |
| St. Lukes Health System Corporation |
5% Or Greater Indirect Ownership Interest | Jun 1, 2016 | 100% |
| 5% Or Greater Indirect Ownership Interest | Feb 1, 2016 | 100% | |
| Commonspirit Health |
5% Or Greater Indirect Ownership Interest | Jun 1, 2016 | 100% |
| 5% Or Greater Indirect Ownership Interest | Feb 1, 2018 | 100% | |
| Robert Upchurch |
Corporate Director |
Jul 1, 2021 | |
| Frank Ashley |
Corporate Director |
Jul 1, 2021 | |
| Brooks Bass |
Corporate Director |
Jul 1, 2021 | |
| Brad Beers |
Corporate Director |
Jul 1, 2021 | |
| Robert Trautman |
Corporate Officer |
Aug 9, 2021 | 100% |
| Jacob Simpson |
W-2 Managing Employee | Jan 1, 2017 | |
| Jason Casey |
Corporate Officer |
Mar 30, 2023 | |
| Operational/Managerial Control |
Mar 30, 2023 | ||
| Jane Ainsworth |
Corporate Director |
Jul 1, 2021 | |
| Indira S Anupindi |
Corporate Director |
Jul 1, 2021 | |
| Demetress L Harrell |
Corporate Director |
Jul 1, 2021 | |
| St Lukes Health Clinical Operations |
5% Or Greater Direct Ownership Interest | Feb 1, 2019 | 100% |
| Operational/Managerial Control | Feb 1, 2019 | 100% | |
| 5% Or Greater Direct Ownership Interest | Feb 1, 2016 | 100% | |
| Operational/Managerial Control | Feb 1, 2016 | 100% | |
| Stephan Laroye Lillie |
Corporate Officer |
May 12, 2026 | |
| Operational/Managerial Control |
May 12, 2026 | ||
| Matthew Brown |
Corporate Officer |
Jul 1, 2025 | |
| Corporate Director |
Jul 1, 2025 | ||
| Terika Richardson Mbanu |
Corporate Director |
Jul 1, 2025 | |
| Donald D Hearne |
Corporate Officer |
Jul 1, 2025 | |
| Michael Lawson |
Corporate Director |
Jul 1, 2025 | |
| Thomas Kopfensteiner |
Corporate Director |
Jul 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060919000191 | TX | Part a Provider - Hospital | 5395707970 | Practice locations: Lake Jackson, TX |
| O20061206000511 | TX | Part a Provider - Hospital | 5395707970 | Practice locations: Lake Jackson, TX |
National Provider Directory
Locations
100B Medical Dr
Lake Jackson, TX 77566
Phone (979) 297-6401
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 000436 | TX | Yes |
Addresses
Primary practice location
100 Medical Dr
Lake Jackson, TX 77566
Mailing address
100 Medical Dr
Lake Jackson, TX 77566
Phone (979) 297-4411
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HH362S | Other | TX | BLUE CROSS SKILLED UNIT |
| 55805 | Other | AMERICAID | |
| HH0471 | Other | TX | BLUE CROSS |
| 6541150 | Other | AETNA | |
| 112671604 | Medicaid | TX | |
| 112764902 | Medicaid | TX | |
| 021787901 | Medicaid | TX | |
| 112671602 | Medicaid | TX |
Other names
- Brazosport Memorial Hospital &Brazosport Regional Health System
- CHI St Luke's Health Brazosport
Other providers in Lake Jackson, TX
- Texas Em-I Medical Services, PA
- Texas Family Solutions, LLC
- Texas Gulf Clinic PA
- Texas Neurosciences PLLC
- Texas South-Personal Homecare Services, Inc.
- The Eye Contact, Inc.
- The Hung Pham,D.D.S., P.a.
- Theory Health Medical PA
- Thomas M Lunsford, MD, Facs, PC
- Antony Bijoy Thomas
All providers in Lake Jackson, TX · General Acute Care Hospital in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.