PARK PLACE TYLER HC, LLC (NPI# 1184954828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184954828 |
| Entity Type | Organization |
| Organization Name | PARK PLACE TYLER HC, LLC |
| Other Organization Name | PARK PLACE NURSING & REHAB |
| Practice Address |
2450 E 5th St Tyler TX 75701-3525 |
| Practice Telephone | 9035926745 |
| Practice Fax Number | 9035921088 |
| Mailing Telephone | 9035926745 |
| Mailing Fax Number | 9035921088 |
| Enumeration Date | 2009-12-31 |
| Last Update Date | 2009-12-31 |
| Authorized Official Name | MS. SHARON KAY REDD (REIMBURSEMENT SPECIALISTS) |
| Authorized Official Telephone | 9038819432 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | TX | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 5390 | 05 | |
| TX | 001012142 | 05 |
| Other Name | Type Code |
|---|---|
| PARK PLACE NURSING & REHAB | Doing Business As Name - Organization |
| Street Address |
2450 E 5TH ST |
| City | TYLER |
| State | TX |
| Zip Code | 75701-3525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629135975 | Park Place Tyler Healthcare, LLC | Skilled Nursing Facility | 2450 E 5th St, Tyler, TX 75701-3525 | 2007-01-03 |
| 1215419387 | Heather N Smith | Occupational Therapy Assistant | 2450 E 5th St, Tyler, TX 75701-3525 | 2018-09-05 |
| 1497237721 | Mary Grace Salanga Mendoza | Physical Therapy Assistant | 2450 E 5th St, Tyler, TX 75701-3525 | 2018-09-04 |
| 1902388465 | Rebecca Lee Robinson | Physical Therapy Assistant | 2450 E 5th St, Tyler, TX 75701-3525 | 2018-08-31 |
| 1477035939 | Carolyn Ann Vieau | Occupational Therapy Assistant | 2450 E 5th St, Tyler, TX 75701-3525 | 2018-08-31 |
| 1598246241 | Tiffany Goodwyn | Physical Therapy Assistant | 2450 E 5th St, Tyler, TX 75701-3525 | 2018-08-21 |
| 1770970543 | Hopkins County Hospital District | Skilled Nursing Facility | 2450 E 5th St, Tyler, TX 75701-3525 | 2015-04-20 |
| 1326384538 | South Park Care & Rehab LLC | Skilled Nursing Facility | 2450 E 5th St, Tyler, TX 75701-3525 | 2012-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326327636 | State of Texas Veterans Land Board | Nursing Facility/Intermediate Care Facility | 11466 Honor Lane, Tyler, TX 78701 | 2011-08-04 |
| 1457681199 | Melrose Hcc, LLC | Nursing Facility/Intermediate Care Facility | 1501 W 29th St, Tyler, TX 75702-1404 | 2009-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922660471 | Castro County Hospital District | Nursing Facility/Intermediate Care Facility | 701 Butler Blvd, Dimmitt, TX 79027-2720 | 2019-07-05 |
| 1023674520 | Eunice Nadine Hall | Nursing Facility/Intermediate Care Facility | 110 W. Troupe St, Mabank, TX 75147-8651 | 2019-05-10 |
| 1467945626 | Regency Ihs of Windsor Mission Oaks LLC | Nursing Facility/Intermediate Care Facility | 3030 S Roosevelt Ave, San Antonio, TX 78214-2337 | 2018-06-12 |
| 1508363086 | Solomon Ishaq | Nursing Facility/Intermediate Care Facility | 1818 Arundel Dr, Carrollton, TX 75007-3012 | 2018-04-10 |
| 1740798651 | Mission Valley Nursing and Transitional Care LLC | Nursing Facility/Intermediate Care Facility | 1200 S Bryan Rd, Mission, TX 78572-6840 | 2018-01-12 |
| 1841738580 | Su Casa Adult Foster Home | Nursing Facility/Intermediate Care Facility | 12462 Paseo De Arco Ct, El Paso, TX 79928-5669 | 2017-02-02 |
| 1225402753 | West Wharton County Hospital District | Nursing Facility/Intermediate Care Facility | 248 Wisteria Ln, El Campo, TX 77437-2545 | 2015-11-20 |
| 1447635040 | Sarah Padlan I | Nursing Facility/Intermediate Care Facility | 3808 Veterans Blvd, Studio 6, Del Rio, TX 78840-2859 | 2015-07-23 |
| 1902289358 | Fnu Anushree | Nursing Facility/Intermediate Care Facility | 328 Bedford Rd Apt 247, Bedford, TX 76022-8032 | 2015-07-02 |
| 1699154278 | Royal Manor Care Center, Inc. | Nursing Facility/Intermediate Care Facility | 4545 S Buckner Blvd, Dallas, TX 75227-4207 | 2015-05-28 |
| Find all providers with the same taxonomy | ||||
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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.