FORT WORTH SKILLED CARE LLC (NPI# 1306239587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306239587 |
| Entity Type | Organization |
| Organization Name | FORT WORTH SKILLED CARE LLC |
| Other Organization Name | IMMANUELS HEALTHCARE |
| Practice Address |
4515 Village Creek Rd Fort Worth TX 76119-4158 |
| Mailing Address |
1019 Holden St Glen Rose TX 76043-4937 |
| Practice Telephone | 8174518704 |
| Practice Fax Number | 8174510048 |
| Mailing Telephone | 2548971430 |
| Mailing Fax Number | 2548971486 |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2015-06-03 |
| Authorized Official Name | MR. BRIAN K THOMAS (MANAGER) |
| Authorized Official Telephone | 2548971430 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 001026850 | 05 | |
| TX | 4529 | 05 |
| Other Name | Type Code |
|---|---|
| Immanuels Healthcare | Doing Business As Name - Organization |
| Street Address |
4515 VILLAGE CREEK RD |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76119-4158 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306843974 | Unlimited Faith, Inc. | Skilled Nursing Facility | 4515 Village Creek Rd, Fort Worth, TX 76119-4158 | 2005-06-28 |
| 1528549250 | Felix Okam | Occupational Therapist | 4515 Village Creek Rd, Fort Worth, TX 76119 | 2018-08-21 |
| 1235619172 | Davina Andrea Deen | Physical Therapy Assistant | 4515 Village Creek Rd, Fort Worth, TX 76119-4158 | 2018-08-20 |
| 1295215069 | Tim Burt Martin | Physical Therapy Assistant | 4515 Village Creek Rd, Fort Worth, TX 76119-4158 | 2018-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467003111 | Asha Jamilia Robertson | Technician | 5321 Rita Kay Ln Lot #21, Fort Worth, TX 76119 | 2019-09-24 |
| 1801366406 | Gina Stovall | Behavioral Analyst | 1100 Circle Drive Suite 101, Fort Worth, TX 76119 | 2018-11-27 |
| 1730660374 | Lisa Alfaro Williams | Counselor | 3120, 22, 24 S.e. Loop 820, Fort Worth, TX 76119 | 2018-08-22 |
| 1023597366 | Gregoire M Butera | Registered Nurse | 3883 Mighty Mite Dr., Fort Worth, TX 76119 | 2018-08-08 |
| 1598244816 | Tawnya R Anderson | Registered Nurse | 3883 Mighty Mite Drive, Fort Worth, TX 76119 | 2018-08-08 |
| 1730699802 | Miller Dental Pllc | Dentist | 3307 Miller Ave Suite #a, Fort Worth, TX 76119 | 2017-10-03 |
| 1053853697 | Carla Walter | Community Health Worker | 4125 Hardeman Ave, Fort Worth, TX 76119 | 2016-11-14 |
| 1710238134 | Thuy Vy Phan | Physician Assistant | 2500 Circle Dr, Fort Worth, TX 76119 | 2012-09-25 |
| 1598031841 | Candace Frances Been | Podiatrist | Federal Bureau of Prisons Federal Medical Center Fort, 3150 Horton Road, Fort Worth, TX 76119 | 2012-03-30 |
| 1053600262 | Miller Dental | Dentist | 3307 Miller Ave Suite A, Fort Worth, TX 76119 | 2011-03-29 |
| Find all providers in zip 76119 | ||||
| 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 |
|---|---|---|---|---|
| 1467973404 | Moc Fort Worth LLC | Skilled Nursing Facility | 6301 Oakmont Blvd, Fort Worth, TX 76132-2814 | 2017-06-29 |
| 1669929642 | Eastland Memorial Hospital District | Skilled Nursing Facility | 4240 Golden Triangle Boulevard, Fort Worth, TX 76244 | 2016-09-07 |
| 1326594052 | Stockyards Healthcare, Inc. | Skilled Nursing Facility | 6301 Oakmont Boulevard, Fort Worth, TX 76132 | 2016-09-01 |
| 1770972572 | Dallas County Hospital District | Skilled Nursing Facility | 7021 Bryant Irvin Rd, Fort Worth, TX 76132-4243 | 2015-01-15 |
| 1497172514 | Stephens Memorial Hospital District | Skilled Nursing Facility | 306 W 7th Strret Suite 430, Fort Worth, TX 76102 | 2014-03-26 |
| 1245662675 | Performance Care Centers LLC | Skilled Nursing Facility | 7021 Bryant Irvin Road, Fort Worth, TX 76132 | 2013-08-08 |
| 1881968808 | Fw Senior Community Ltd Co | Skilled Nursing Facility | 4600 Heritage Trace Pkwy, Fort Worth, TX 76244-8900 | 2012-03-08 |
| 1750679098 | Tarrant County Senior Living Center, Inc. | Skilled Nursing Facility | 2501 Museum Way, Fort Worth, TX 76107-3057 | 2011-07-20 |
| 1386949220 | Remarkable Healthcare of Fort Worth, Lp | Skilled Nursing Facility | 6649 North Riverside Drive, Fort Worth, TX 76137 | 2011-01-25 |
| 1679895163 | Decatur Hospital Authority | Skilled Nursing Facility | 850 12th Ave., Fort Worth, TX 76104-2516 | 2010-02-24 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76119 |
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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.