Providence Park, Inc.
NPI 1720086655 · Skilled Nursing Facility · Waco, TX
Enrolled with Medicare as Part a Provider - Skilled Nursing Facility · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Providence Park, Inc. is a Skilled Nursing Facility organization in Waco, TX (NPI 1720086655).
Provider details
- NPI number
- 1720086655
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Erin Shadbolt, Ceo(314) 729-3500
- License
- 108085 (TX)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Nursing & Custodial Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Ascension Living Providence Village
- Doing business as
- Ascension Living Providence Village
- Other name
- St. Catherine Center
Registry dates
- Enumerated
- 2005-07-13
- Last updated
- 2025-06-23
- Certified
- 2025-06-23
Frequently asked questions
- What is Providence Park, Inc.'s NPI number?
- Providence Park, Inc.'s National Provider Identifier (NPI) is 1720086655, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Providence Park, Inc.?
- Providence Park, Inc. is classified in the NPPES registry as Skilled Nursing Facility (Nursing & Custodial Care Facilities).
- Where is Providence Park, Inc. located?
- Providence Park, Inc.'s practice location on file with NPPES is 300 W Highway 6, Waco, TX 76712-4041.
- What is Providence Park, Inc.'s phone number?
- The practice phone number listed in the NPPES registry for Providence Park, Inc. is (254) 761-8500.
- Does Providence Park, Inc. accept Medicare?
- Providence Park, Inc. is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Providence Park, Inc.?
- The authorized official listed on Providence Park, Inc.'s NPPES record is Erin Shadbolt, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Providence Park, Inc.'s NPI active?
- Yes — Providence Park, Inc.'s NPI (1720086655) is active in the NPPES registry as of the last update on 2025-06-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.