ETHICUS HOSPITAL DFW LLC (NPI# 1659536944) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659536944 |
| Entity Type | Organization |
| Organization Name | ETHICUS HOSPITAL DFW LLC |
| Other Organization Name | SAGECREST HOSPITAL GRAPEVINE |
| Practice Address |
4201 William D Tate Ave Grapevine TX 76051-5736 |
| Practice Telephone | 8172881300 |
| Practice Fax Number | 8172881499 |
| Mailing Telephone | 8172881300 |
| Mailing Fax Number | 8172881499 |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2019-10-22 |
| Authorized Official Name | MR. JORDAN FOWLER (CEO) |
| Authorized Official Telephone | 8172881300 |
| Is Organization Subpart | Y |
| Parent Organization Name | ETHICUS HOSPITAL GRAPEVINE LP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282E00000X | Long Term Care Hospital | 008742 | TX | Hospitals |
| Other Name | Type Code |
|---|---|
| Ethicus Hospital - Grapevine | Doing Business As Name - Organization |
| Sagecrest Hospital Grapevine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316505043 | Ethicus Hospital Dfw LLC | General Acute Care Hospital | 1401 E. Trinity Mills Road, Carroliton, TX 75006 | 2019-05-29 |
| Street Address |
4201 WILLIAM D TATE AVE |
| City | GRAPEVINE |
| State | TX |
| Zip Code | 76051-5736 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881227346 | Jeffrey Joseph Cervenka | Physical Therapist | 2421 Ira E Woods Ave #101, Grapevine, TX 76051 | 2020-02-12 |
| 1871137562 | Karen Lorince | Counselor | 2409 N. Support Road, Grapevine, TX 76051 | 2019-11-05 |
| 1548733785 | Jessica Thorman Johnson | Dietitian, Registered | 1056 Texan Trail (fortis Bmi), Grapevine, TX 76051 | 2019-01-10 |
| 1164928958 | Kristen Diou | Counselor | 913 S Church St Ste 103, Grapevine, TX 76051 | 2018-04-02 |
| 1356860597 | Anissa Singratanakul D.m.d, Pllc | Dentist | 1231 William D Tate Suite 400, Grapevine, TX 76051 | 2017-09-19 |
| 1033637665 | James Abraham Thomas | Pharmacy | 1601 W. State Hwy 114, Grapevine, TX 76051 | 2017-09-04 |
| 1437606563 | D'anna Sims | Counselor | 2451 Stone Myers Parkway, #100, Grapevine, TX 76051 | 2016-09-07 |
| 1477006369 | Melinda Jeanne Mashburn | Nurse Practitioner | 1600 West College St., Suite 60, Grapevine, TX 76051 | 2016-07-27 |
| 1437506623 | Allcare Physicians Group | Registered Nurse | 1111 S Main St Ste 119, Grapevine, TX 76051 | 2016-05-18 |
| 1790141745 | Colwick Counseling | Clinic/Center | 1400 W. Northwest Highway Suite 260, Grapevine, TX 76051 | 2016-01-06 |
| Find all providers in zip 76051 | ||||
| Taxonomy Code | 282E00000X |
| Grouping | Hospitals |
| Classification | Long Term Care Hospital |
| Long-term care hospitals (LTCHs) furnish extended medical and rehabilitative care to individuals who are clinically complex and have multiple acute or chronic conditions. |
| Notes: Source: American Hospital Association [7/1/2006: new] |
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| 1699121350 | Baylor College of Medicine | Long Term Care Hospital | 8660 Memorial Dr, Houston, TX 77024-7014 | 2016-05-11 |
| 1841656543 | Dicomity Solutions | Long Term Care Hospital | 17113 Tortoise St, Round Rock, TX 78664-8517 | 2016-01-11 |
| 1457730426 | Chg Hospital Houston, LLC | Long Term Care Hospital | 709 W Medical Center Blvd, Webster, TX 77598-4005 | 2015-05-23 |
| 1689063679 | Lourdes T Ortiz | Long Term Care Hospital | 5806 Providence Oak, San Antonio, TX 78249-4878 | 2015-01-14 |
| 1295139749 | Atrium Medical Center | Long Term Care Hospital | 5931 Mettler Ln, Richmond, TX 77469-2240 | 2014-10-13 |
| 1467853051 | Pam Squared At Corpus Christi, LLC | Long Term Care Hospital | 600 Elizabeth St Fl 3, Corpus Christi, TX 78404-2235 | 2014-09-15 |
| 1548672108 | Pan American Diabetes Foundation | Long Term Care Hospital | 705 Cervantes Ct, El Paso, TX 79922-2102 | 2014-05-29 |
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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.