INDEPENDENT ORDER OF ODD FELLOWS GRAND LODGE 100F OF TEXAS (NPI# 1598751166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598751166 |
| Entity Type | Organization |
| Organization Name | INDEPENDENT ORDER OF ODD FELLOWS GRAND LODGE 100F OF TEXAS |
| Other Organization Name | ODD FELLOW AND REBEKAH NURSING HOME |
| Practice Address |
2300 S Oak Grove Rd Ennis TX 75119-6841 |
| Practice Telephone | 9728758643 |
| Practice Fax Number | 9728751179 |
| Mailing Telephone | 9728758643 |
| Mailing Fax Number | 9728751179 |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2019-02-13 |
| Authorized Official Name | JAMES M CURTIS (GRAND SECRETARY) |
| Authorized Official Telephone | 9038727438 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 114389 | TX | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 190096101 | 05 | |
| TX | 000456001 | 05 |
| Other Name | Type Code |
|---|---|
| ODD FELLOW & REBEKAH NURSING HOME | Doing Business As Name - Organization |
| Odd Fellow and Rebekah Nursing Home | Doing Business As Name - Organization |
| Street Address |
2300 S OAK GROVE RD |
| City | ENNIS |
| State | TX |
| Zip Code | 75119-6841 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538624507 | Coryell County Memorial Hospital Authority | Skilled Nursing Facility | 2300 S Oak Grove Rd, Ennis, TX 75119-6841 | 2019-02-04 |
| 1295207132 | Mallory L Martin | Physical Therapy Assistant | 2300 S Oak Grove Rd, Ennis, TX 75119-6841 | 2018-12-17 |
| 1689144594 | Angela Kellam | Physical Therapy Assistant | 2300 S Oak Grove Rd, Ennis, TX 75119-6841 | 2018-12-04 |
| 1851872519 | Trissha Belle Balangue Bautista | Occupational Therapy Assistant | 2300 S Oak Grove Rd, Ennis, TX 75119-6841 | 2018-08-22 |
| 1801377510 | Linda Carol Mach | Occupational Therapy Assistant | 2300 S Oak Grove Rd, Ennis, TX 75119-6841 | 2018-08-22 |
| 1558841338 | Stephanie Lee Humann | Occupational Therapy Assistant | 2300 S Oak Grove Rd, Ennis, TX 75119-6841 | 2018-08-21 |
| 1013497767 | Sherri Lynn Berry | Occupational Therapy Assistant | 2300 S Oak Grove Rd, Ennis, TX 75119-6841 | 2018-08-21 |
| 1538489513 | Harichandra Vennelakanti | Physical Therapist | 2300 S Oak Grove Rd, Ennis, TX 75119-6841 | 2010-06-02 |
| 1396972337 | Gerald Noterman | Physical Therapist | 2300 S Oak Grove Rd, Ennis, TX 75119-6841 | 2009-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174121859 | Alexandria Etuk | Pharmacist | 101 Sh-437 Spur, Ennis, TX 75119 | 2020-10-14 |
| 1285279158 | Oluchi Ozumba Md Pa | Pain Medicine | 601 S Cly St, Suite 104, Ennis, TX 75119 | 2019-11-14 |
| 1952806085 | Ikids Pediatric Dentistry Ennis, Pllc | Dentist | 711 S Clay St Ste A, Ennis, TX 75119 | 2018-03-29 |
| 1609382068 | Living Single LLC | Residential Treatment Facility, Physical Disabilities | 809 E. Denton Street, Ennis, TX 75119 | 2017-12-21 |
| 1912363300 | Erin Denise Jackson | Counselor | 219 W. Brown St, Suite A, Ennis, TX 75119 | 2016-01-14 |
| 1164769139 | Matthew Garrett Cooper | Nurse Anesthetist, Certified Registered | 2201 W. Lampasas Street, Ennis, TX 75119 | 2013-01-11 |
| 1922343805 | Braces R Us PC | Dentist | 1012 E. Ennis Ave. Ste. C, Ennis, TX 75119 | 2012-12-04 |
| 1154684355 | Stefanie Nicole Rust | Emergency Medicine | 2201 West Lampasas Street, Ennis, TX 75119 | 2012-06-21 |
| 1265710909 | Traditions Health Care of Ennis, LLC | Home Health | 109 Southwest Main Street, Suite A, Ennis, TX 75119 | 2011-07-29 |
| 1578792370 | Peak Physical Therapy and Rehabilitation LLC | Physical Therapist | 2200 Physicians Blvd, Ste D, Ennis, TX 75119 | 2009-07-14 |
| Find all providers in zip 75119 | ||||
| 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 |
|---|---|---|---|---|
| 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.