CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY (NPI# 1619467842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619467842 |
| Entity Type | Organization |
| Organization Name | CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY |
| Other Organization Name | FT. WORTH WELLNESS & REHABILITATION |
| Practice Address |
2129 Skyline Dr Fort Worth TX 76114-1924 |
| Mailing Address |
1507 W Main St Gatesville TX 76528-1024 |
| Practice Telephone | 8176261956 |
| Mailing Telephone | 2542486245 |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2018-05-14 |
| Authorized Official Name | DAVID BYROM (CEO) |
| Authorized Official Telephone | 2542486245 |
| 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 |
|---|---|
| Ft. Worth Wellness & Rehabilitation | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780298547 | Coryell County Memorial Hospital Authority | Clinic/Center | 498 Avenue E, Moody, TX 76557-3579 | 2020-08-31 |
| 1780124594 | Coryell County Memorial Hospital Authority | Skilled Nursing Facility | 121 Commons, Athens, TX 75751-0009 | 2017-02-27 |
| 1962891523 | Coryell County Memorial Hospital Authority | Skilled Nursing Facility | 3505 S Buckner Blvd Bldg 5, Dallas, TX 75227-5451 | 2015-01-20 |
| 1952531824 | Coryell County Memorial Hospital Authority | Family Medicine | 3401 East Main Street, Gatesville, TX 76528-1028 | 2009-07-24 |
| 1457468431 | Coryell County Memorial Hospital Authority | Skilled Nursing Facility | 7801 Woodway Dr, Woodway, TX 76712-3860 | 2006-08-24 |
| 1669589610 | Coryell County Memorial Hospital Authority | Skilled Nursing Facility | 8501 Laurens Ln, San Antonio, TX 78218-6092 | 2006-08-24 |
| 1447296264 | Coryell County Memorial Hospital Authority | Nursing Facility/Intermediate Care Facility | 110 Chicktown Road, Gatesville, TX 76528-1035 | 2006-06-21 |
| 1518900778 | Coryell County Memorial Hospital Authority | Clinic/Center | 1510 Hannah Valley Rd, Goldthwaite, TX 76844-2533 | 2006-06-14 |
| 1568417491 | Coryell County Memorial Hospital Authority | Emergency Medicine | 1507 West Main Street, Gatesville, TX 76528-1024 | 2006-05-22 |
| 1538624507 | Coryell County Memorial Hospital Authority | Skilled Nursing Facility | 2300 S Oak Grove Rd, Ennis, TX 75119-6841 | 2019-02-04 |
| Street Address |
2129 SKYLINE DR |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76114-1924 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679511794 | Heather Denise Breiter | Psychologist | 2129 Skyline Dr, Fort Worth, TX 76114-1924 | 2006-06-02 |
| 1417136540 | Doctors Eyewear Inc. | Optometrist | 2129 Skyline Dr, Fort Worth, TX 76114-1924 | 2007-10-25 |
| 1164538245 | Roma S. Eckrich | Psychologist | 2129 Skyline Dr, Fort Worth, TX 76114-1924 | 2006-08-22 |
| 1770512691 | Jo Ann Houts | Psychologist | 2129 Skyline Dr, Fort Worth, TX 76114-1924 | 2006-07-02 |
| 1912940701 | Manor Care of Fort Worth Tx (nw) LLC | Skilled Nursing Facility | 2129 Skyline Dr, Fort Worth, TX 76114-1924 | 2006-06-13 |
| 1487692216 | Doris Matney Weatherly | Psychologist | 2129 Skyline Dr, Fort Worth, TX 76114-1924 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952917957 | Jennie Bauchert | Massage Therapist | 1205 Roaring Springs Rd., Ft Worth, TX 76114 | 2020-09-16 |
| 1417438243 | North Texas Area Community Health Centers, Inc | Pharmacy | 2332 Beverly Hills Drive Ste 1116, Ft. Worth, TX 76114 | 2018-08-29 |
| 1023525573 | Jennifer Christine Arriaga | Occupational Therapy Assistant | 125 Smallwood, Fort Worth, TX 76114 | 2018-01-05 |
| 1831617216 | Kailene Allis | Specialist/Technologist | 5519 Norte Dame Ave, River Oaks, TX 76114 | 2017-09-06 |
| 1336662022 | Ben Luka | Dentist | 639 Alta Mere Dr, Fort Worth, TX 76114 | 2017-07-25 |
| 1750771382 | Signature Family Dentistry Pllc | Dentist | 4839 River Oaks Blvd., River Oaks, TX 76114 | 2015-02-04 |
| 1447668223 | Wal-mart Stores Texas, LLC | Technician/Technologist | 2245 Jacksonboro Hwy, Ft. Worth, TX 76114 | 2014-07-24 |
| 1558611897 | Walgreens | Pharmacist | 5716 Aton Ave, Westworth Village, TX 76114 | 2012-09-13 |
| 1437439551 | Ashley Kristen Murrey | Dentist | 6628 Westworth Blvd, Westworth Village, TX 76114 | 2011-08-20 |
| 1598054637 | Ashley Anne Trabon | Physician Assistant | 4819 River Oaks, Fort Worth, TX 76114 | 2011-03-29 |
| Find all providers in zip 76114 | ||||
| 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 | 76114 |
Please comment or provide details below to improve the information on CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY.
| 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.