CROCKETT SENIOR CARE, LLC (NPI# 1063858298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063858298 |
| Entity Type | Organization |
| Organization Name | CROCKETT SENIOR CARE, LLC |
| Other Organization Name | PITTSBURG NURSING CENTER |
| Practice Address |
200 W State Hwy 6 Suite 612 Waco TX 76712 |
| Mailing Address |
200 W State Highway 6 Suite 612 Waco TX 76712-7923 |
| Practice Telephone | 2543996788 |
| Practice Fax Number | 2543996766 |
| Mailing Telephone | 2543996788 |
| Mailing Fax Number | 2543996766 |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2015-04-14 |
| Authorized Official Name | JACK COOK (MEMBER) |
| Authorized Official Telephone | 2543996788 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | TX | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 001021232 | 05 |
| Other Name | Type Code |
|---|---|
| PITTSBURG NURSING CENTER | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | CROCKETT SENIOR CARE, LLC | 1000 Legion Pl #1600, Orlando, FL 32801 |
| Street Address |
200 W STATE HWY 6 SUITE 612 |
| City | WACO |
| State | TX |
| Zip Code | 76712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922634294 | Waco Ophthalmology, Pllc | Ophthalmology | 602 W Highway 6, Waco, TX 76712 | 2020-03-19 |
| 1326692872 | Oceans Behavioral Hospital of Waco LLC | Psychiatric Hospital | 5931 Crosslake Parkway, Waco, TX 76712 | 2019-08-01 |
| 1831759620 | Jessica Ngoc Vien | Optometrist | 1000 Hwy 6, Ste 210, Waco, TX 76712 | 2019-06-14 |
| 1780150888 | Chelsea Cannon | Occupational Therapist | 330 W State Hwy 6, Waco, TX 76712 | 2018-10-17 |
| 1669955399 | Elizabeth Ann Barnhill | Speech-Language Pathologist | 15003 Riatta Rd, Woodway, TX 76712 | 2018-09-09 |
| 1447731617 | Melanie A Melton | Physical Therapist | 300 West Highway 6, Waco, TX 76712 | 2018-08-27 |
| 1396226403 | Gala Kaye Czajkoski | Occupational Therapy Assistant | 300 West Hightway 6, Waco, TX 76712 | 2018-08-27 |
| 1619457454 | Monica Anderson | Physical Therapy Assistant | 300 W Hwy 6, Waco, TX 76712 | 2018-08-21 |
| 1295238368 | Waco Sn Opco LLC | Skilled Nursing Facility | 7501 Bagby, Waco, TX 76712 | 2018-03-14 |
| 1558872952 | C. Guy Fps, Pllc | Otolaryngology | 1129 Aberdeen Rd, Waco, TX 76712 | 2017-10-12 |
| Find all providers in zip 76712 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598237133 | St. Anthony's Care Center LLC | Skilled Nursing Facility | 7501 Bagby Ave, Waco, TX 76712-6904 | 2018-12-20 |
| 1538631171 | Fourcooks Senior Care, LLC | Skilled Nursing Facility | 329 W Hwy 6 Ste C, Waco, TX 76710-5574 | 2018-12-20 |
| 1295238368 | Waco Sn Opco LLC | Skilled Nursing Facility | 7501 Bagby, Waco, TX 76712 | 2018-03-14 |
| 1790299659 | Woodgate Snf Realty LLC | Skilled Nursing Facility | 6500 Horizon Cir, Waco, TX 76712-6985 | 2017-11-29 |
| 1134501869 | Market Place Health Care, LLC | Skilled Nursing Facility | 2430 Market Place Drive, Waco, TX 76711 | 2015-06-18 |
| 1669714168 | Royal Manor II | Skilled Nursing Facility | 9101 Panther Way, Waco, TX 76712-8614 | 2013-03-22 |
| 1548591092 | Virginia Marie Humann | Skilled Nursing Facility | 100 Jeffery Street, Waco, TX 76710 | 2010-01-22 |
| 1003085135 | Woodland Springs Healthcare Lp | Skilled Nursing Facility | 1010 Dallas St, Waco, TX 76704 | 2008-02-22 |
| 1497876965 | Seminole Hospital District of Gaines County Texas | Skilled Nursing Facility | 401 Owen Ln, Waco, TX 76710-5558 | 2007-04-03 |
| 1689697344 | Ridgecrest Retirement Center and Healthcare | Skilled Nursing Facility | 1900 W State Highway 6, Waco, TX 76712-9729 | 2006-07-25 |
| Find all providers in WACO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.