SOUTHWEST LTC KILGORE LTD (NPI# 1619287273) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619287273 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST LTC KILGORE LTD |
| Other Organization Name | THE WILLOWS OF KILGORE |
| Practice Address |
1901 Whipporwill Ln Kilgore TX 75662-3880 |
| Practice Telephone | 9039837775 |
| Practice Fax Number | 9039842244 |
| Mailing Telephone | 9039837775 |
| Mailing Fax Number | 9039842244 |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2010-11-08 |
| Authorized Official Name | RONALD R PAYNE (MANAGER) |
| Authorized Official Telephone | 4699166100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| The Willows of Kilgore | Doing Business As Name - Organization |
| Street Address |
1901 WHIPPORWILL LN |
| City | KILGORE |
| State | TX |
| Zip Code | 75662-3880 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336124643 | Willow Bluff LLC | Skilled Nursing Facility | 1901 Whipporwill Ln, Kilgore, TX 75662-3880 | 2005-12-08 |
| 1376942656 | Titus County Hospital District | Skilled Nursing Facility | 1901 Whipporwill Ln, Kilgore, TX 75662-3880 | 2014-08-22 |
| 1639423262 | Willow Snf LLC | Skilled Nursing Facility | 1901 Whipporwill Ln, Kilgore, TX 75662-3880 | 2012-11-05 |
| 1174831879 | Shana Michelle Deal | Speech-Language Pathologist | 1901 Whipporwill Ln, Kilgore, TX 75662-3880 | 2010-09-16 |
| 1013245703 | Leslie N Greenhouse | Occupational Therapist | 1901 Whipporwill Ln, Kilgore, TX 75662-3880 | 2009-11-18 |
| 1083844252 | Melissa Ann Hahn | Physical Therapy Assistant | 1901 Whipporwill Ln, Kilgore, TX 75662-3880 | 2009-07-21 |
| 1386805992 | Brenda V. Chaplin | Physical Therapy Assistant | 1901 Whipporwill Ln, Kilgore, TX 75662-3880 | 2008-06-17 |
| 1023276318 | Katrina Denean Johnson | Occupational Therapy Assistant | 1901 Whipporwill Ln, Kilgore, TX 75662-3880 | 2008-05-23 |
| 1104023845 | Teresa Gail Agee | Speech-Language Pathologist | 1901 Whipporwill Ln, Kilgore, TX 75662-3880 | 2007-06-27 |
| 1457557233 | Lashonda Gale Portley | Occupational Therapist | 1901 Whipporwill Ln, Kilgore, TX 75662-3880 | 2007-06-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346890621 | Linda Gail Watson | Technician | 190 Glendale St, Kilgore, TX 75662 | 2019-09-18 |
| 1174185151 | Jennifer Darlene Franks | Registered Nurse | 6144 Gateway Center Pmb # 320, Kilgore, TX 75662 | 2019-07-01 |
| 1215363312 | Kilgore Integrated Health Pllc | Chiropractor | 726 Us Highway 259 N, Kilgore, TX 75662 | 2013-09-20 |
| 1407172240 | Jeffrey Alan Davis | Specialist/Technologist | 300 N. Kilgore Street, Kilgore, TX 75662 | 2010-04-19 |
| 1396923777 | Rachel Thunder Rose Wyatt | Physical Therapist | 1200 Dudley Road, Kilgore, TX 75662 | 2008-02-07 |
| 1346313673 | Brookshire Grocery Company | Pharmacy | 747 Hwy 259 North, Attention Pharmacy Dept, Kilgore, TX 75662 | 2006-11-16 |
| 1417026451 | Jeffery John Pinkerton | Optometrist | 800 Highway 259 North, Kilgore, TX 75662 | 2006-11-06 |
| 1831205004 | Joseph Claude De Graffenried Jr. | Dentist | 238 Lawrence St, Kilgore, TX 75662 | 2006-08-21 |
| 1235159500 | Charles Robert Cottier | Chiropractor | 316 Henderson, Kilgome, TX 75662 | 2006-07-20 |
| 1346509494 | Kelton Hospice, Inc. | Hospice Care, Community Based | 1100 Stone Road, Suite 269, Kilgore, TX 75662 | 2012-05-10 |
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| 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 |
|---|---|---|---|---|
| 1336124643 | Willow Bluff LLC | Skilled Nursing Facility | 1901 Whipporwill Ln, Kilgore, TX 75662-3880 | 2005-12-08 |
| 1538679931 | Mpd Texas Resources of Kilgore LLC | Skilled Nursing Facility | 2700 S Henderson Blvd, Kilgore, TX 75662-4033 | 2017-10-11 |
| 1083011787 | Kilgore Healthcare LLC | Skilled Nursing Facility | 2700 S Henderson Blvd, Kilgore, TX 75662-4033 | 2014-11-24 |
| 1376942656 | Titus County Hospital District | Skilled Nursing Facility | 1901 Whipporwill Ln, Kilgore, TX 75662-3880 | 2014-08-22 |
| 1164854691 | Arbor Grace Skilled Nursing and Rehabilitation LLC | Skilled Nursing Facility | 144 Fm 1252 W, Kilgore, TX 75662-5093 | 2013-08-07 |
| 1639423262 | Willow Snf LLC | Skilled Nursing Facility | 1901 Whipporwill Ln, Kilgore, TX 75662-3880 | 2012-11-05 |
| 1992021661 | Kilgore I Enterprises, LLC | Skilled Nursing Facility | 2700 S Henderson Blvd, Kilgore, TX 75662-4033 | 2010-04-20 |
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|---|---|---|---|---|
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| 1649884313 | Springtown Ventures Lp | Skilled Nursing Facility | 201 Williams Ward Rd., Springtown, TX 76082 | 2020-09-01 |
| 1821601691 | Altamira Healthcare LLC | Skilled Nursing Facility | 200 Carla St, Zapata, TX 78076-3114 | 2020-08-31 |
| 1538770839 | Go Operations 3 LLC | Skilled Nursing Facility | 4366 Lockhill Selma, Shavano, TX 78249 | 2020-08-11 |
| 1912516329 | Patriot Skilled Nursing and Rehabilitation LLC | Skilled Nursing Facility | 11490 Gateway N Blvd., El Paso, TX 79934 | 2020-07-31 |
| 1972112464 | The Brixton At Horseshoe Bay | Skilled Nursing Facility | 15101 West Fm 2147, Horseshoe Bay, TX 78657 | 2020-07-30 |
| 1558984278 | Slp Johnson City LLC | Skilled Nursing Facility | 206 Haley Rd, Johnson City, TX 78636-4617 | 2020-05-28 |
| 1073136149 | Continuum Rehab Group | Skilled Nursing Facility | 3326 Burgoyne St # 1432, Dallas, TX 75233-1304 | 2020-05-24 |
| 1750904264 | Frank Villanueva | Skilled Nursing Facility | 711 W Broadway St, Denver City, TX 79323-3000 | 2020-05-19 |
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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.