HERITAGE CONVALESCENT CENTER, LTD (NPI# 1497745723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497745723 |
| Entity Type | Organization |
| Organization Name | HERITAGE CONVALESCENT CENTER, LTD |
| Other Organization Name | HERITAGE CONVALESCENT CENTER |
| Practice Address |
1009 Clyde St Amarillo TX 79106-4225 |
| Practice Telephone | 8063525295 |
| Practice Fax Number | 8063526635 |
| Mailing Telephone | 8063525295 |
| Mailing Fax Number | 8063526635 |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. RUEGENA DAVIDSON (ADMINISTRATOR) |
| Authorized Official Telephone | 8063525295 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | TX | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Heritage Convalescent Center | Doing Business As Name - Organization |
| Street Address |
1009 CLYDE ST |
| City | AMARILLO |
| State | TX |
| Zip Code | 79106-4225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992288948 | Timothy Jones | Occupational Therapy Assistant | 1009 Clyde St, Amarillo, TX 79106 | 2018-09-14 |
| 1164905568 | Truman Gordon Hill II | Physical Therapy Assistant | 1009 Clyde St, Amarillo, TX 79106-4225 | 2018-09-11 |
| 1487137873 | Roberto Rangel | Physical Therapy Assistant | 1009 Clyde St, Amarillo, TX 79106-4225 | 2018-09-11 |
| 1932682531 | Edna Harris | Physical Medicine & Rehabilitation | 1009 Clyde St, Amarillo, TX 79106-4225 | 2018-09-10 |
| 1851874572 | Peggy Ann Forsythe | Physical Therapy Assistant | 1009 Clyde St, Amarillo, TX 79106-4225 | 2018-09-09 |
| 1952776627 | Crysta Carducci | Speech-Language Pathologist | 1009 Clyde St, Amarillo, TX 79106-4225 | 2015-12-07 |
| 1043527054 | Shanna R Horton | Music Therapist | 1009 Clyde St, Amarillo, TX 79106-4225 | 2010-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538773205 | Nisha Patel | Pharmacist | 1600 S Western Street, Amarillo, TX 79106 | 2020-09-01 |
| 1043851769 | Diana Moore | Pharmacist | 6010 Amarillo Blvd W (119), Amarillo, TX 79106 | 2019-10-03 |
| 1164988127 | Wade Family Services Pllc | Counselor | 1901 Medi Park Dr Suite 130, Amarillo, TX 79106 | 2019-02-14 |
| 1255802963 | Jennifer Cockrum | Hospitalist | Bsa Hospitalist, 1600 Wallace Blvd., Amarillo, TX 79106 | 2018-12-07 |
| 1346736691 | Denise Mills Donnell | Social Worker | 6010 Amarillo Bouldevard West Clc-b, Amarillo, TX 79106 | 2018-07-10 |
| 1124525472 | Abigail Batson | Student in an Organized Health Care Education/Training Program | 1400 S Coulter Street, Suite 1500, Amarillo, TX 79106 | 2018-04-11 |
| 1053812743 | Moc Amarillo, LLC | Skilled Nursing Facility | 1540 Research St., Amarillo, TX 79106 | 2018-02-27 |
| 1013459437 | Larry G. Schulz | Durable Medical Equipment & Medical Supplies | 1901 Medi Park Dr Ste 219, Amarillo, TX 79106 | 2016-11-16 |
| 1922453315 | Omar Saeed M Alzhrani | Student in an Organized Health Care Education/Training Program | 1400 S. Coulter - Suite 5100, Amarillo, TX 79106 | 2016-05-04 |
| 1972967529 | David Wayne Hohon | Internal Medicine | Bsa Physician Group, 1600 Wallace Blvd., Amarillo, TX 79106 | 2016-04-11 |
| Find all providers in zip 79106 | ||||
| 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 |
|---|---|---|---|---|
| 1356831721 | Amarillo Vii Enterprises, LLC | Skilled Nursing Facility | 1625 Point West Parkway, Amarillo, TX 79124 | 2018-05-11 |
| 1053812743 | Moc Amarillo, LLC | Skilled Nursing Facility | 1540 Research St., Amarillo, TX 79106 | 2018-02-27 |
| 1518357680 | Hemphill County Hospital District | Skilled Nursing Facility | 5500 Sw 9th Ave, Amarillo, TX 79106-4100 | 2015-01-28 |
| 1700228632 | Amarillo II Enterprises, LLC | Skilled Nursing Facility | 6641 W Amarillo Blvd, Amarillo, TX 79106-1755 | 2013-07-19 |
| 1942446133 | Amarillo Vi Enterprises, LLC | Skilled Nursing Facility | 2611 Sw 46th Ave, Amarillo, TX 79110-1735 | 2008-12-18 |
| 1699964098 | Ted M. Nicklaus | Skilled Nursing Facility | 101 Wallace Blvd, Amarillo, TX 79106 | 2007-10-22 |
| 1467678615 | State of Texas Veterans Land Board | Skilled Nursing Facility | 1020 Tascosa Road, Amarillo, TX 79124-1504 | 2007-04-17 |
| 1063509248 | Stratford Hospital District | Skilled Nursing Facility | 6650 S Soncy Rd, Amarillo, TX 79119-6655 | 2006-10-07 |
| 1609806579 | Lee Bivins Foundation | Skilled Nursing Facility | 6600 Killgore Dr, Amarillo, TX 79106-3700 | 2006-07-04 |
| 1467439299 | Moore Health Services Corporation | Skilled Nursing Facility | 2611 W 46th Ave, Amarillo, TX 79110-1735 | 2005-12-22 |
| Find all providers in AMARILLO | ||||
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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.