MEDALLION (NPI# 1750503892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750503892 |
| Entity Type | Organization |
| Organization Name | MEDALLION |
| Practice Address |
12400 Preston Road Dallas TX 75230 |
| Mailing Address |
Po Box 3006 Salem OR 97302 |
| Practice Telephone | 9726613111 |
| Practice Fax Number | 5034851279 |
| Mailing Telephone | 5034858697 |
| Mailing Fax Number | 5034851279 |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JON HARDER (PRESIDENT) |
| Authorized Official Telephone | 5034858697 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | MEDALLION 4F92 LLC | 132 9th Ave, New York, Ny 10011 |
| New York State Corporations | MEDALLION 6E84 INC. | 11a Concord Rd, West Milford, Nj 074801271 |
| New York State Corporations | MEDALLION ABSTRACT, LLC | 333 Earle Ovington Blvd., Uniondale, Ny 11103 |
| Connecticut Business Registrations | MEDALLION AIR, INC. | 36 Pitton Drive, Commack, NY 11725 |
| Colorado Business Entities | Medallion Aircell, LLC | 270 St. Paul Street, Suite 300, Denver, CO 80206 |
| Colorado Business Entities | Medallion Alpha Portfolio I, LP | 270 St. Paul Street, Suite 200, Denver, CO 80206 |
| Oregon Corporations, Companies and Business Names | MEDALLION ART L.L.C. | 304 Ne Crestwood Ct, Vancouver, WA 98684 |
| Oregon Corporations, Companies and Business Names | MEDALLION ART SCHOOLS | 304 Ne Crestwood Ct, Vancouver, WA 98684 |
| Colorado Business Entities | Medallion Asset Management, LLC | 270 St. Paul Street, Suite 300, Denver, CO 80206 |
| New York State Corporations | MEDALLION ASSOCIATES LTD. | 135 Grand St, Carlstadt, Nj 07072 |
| Street Address |
12400 PRESTON ROAD |
| City | DALLAS |
| State | TX |
| Zip Code | 75230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912552415 | Kyoto Medical Services, Pllc | Orthopaedic Surgery | 12890 Hillcrest Plaza Drive, Suite K111, Dallas, TX 75230 | 2019-08-02 |
| 1528538170 | Angel Laamber Adams | Nurse Practitioner | 7777 Forest Lane Suite C 833, Dallas, TX 75230 | 2018-11-27 |
| 1538634399 | Tochukwu Chioma Uche-ukah | Nurse Practitioner | Dr Katari, Encompass Health Rehabilitations, 7930 Northaven Rd, Dallas, TX 75230 | 2018-10-09 |
| 1790260958 | Ability Aba, Pllc | Behavioral Analyst | 5930 Royal Lane Ste E, #301, Dallas, TX 75230 | 2018-10-03 |
| 1750887956 | Brandi Nicole Freeman | Behavioral Analyst | 5639 Mcshann Rd, Dallas, TX 75230 | 2018-04-05 |
| 1326547720 | Whitney A Stewart | Psychologist | 5924 Royal Lane, Ste 258, Preston Hollow Health & Wellness, Dallas, TX 75230 | 2018-02-12 |
| 1407384373 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 7859 Walnut Hill Ln Ste 110, Dallas, TX 75230 | 2017-05-23 |
| 1215488648 | The Walker Wellness Clinic | Community/Behavioral Health | 12200 Preston Rd., Dallas, TX 75230 | 2016-10-20 |
| 1578912325 | Renat Kudyakov | Nurse Practitioner | 7777 Forest Ln Ste B-446, Dallas, TX 75230 | 2016-06-11 |
| 1407210982 | Rohan Venugopal Menon | Pediatrics | 7777 Forest Lane, Bldg B 300, Dallas, TX 75230 | 2016-04-11 |
| Find all providers in zip 75230 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215492483 | Talco House Assisted Living | Assisted Living Facility | 2328 Talco Dr, Dallas, TX 75241-1423 | 2019-02-01 |
| 1174017057 | Blessings of Love Corporation | Assisted Living Facility | 1208 Willow Glen Dr, Dallas, TX 75232-2438 | 2018-06-14 |
| 1497250005 | Entrust Senior Living of Desoto LLC | Assisted Living Facility | 8027 W Virginia Dr, Dallas, TX 75237-3767 | 2018-03-26 |
| 1235646902 | Dominique Brackens | Assisted Living Facility | 6005 Park Manor Dr, Dallas, TX 75241-5241 | 2018-01-04 |
| 1265942338 | Kimberlee Williams | Assisted Living Facility | 7412 S Lancaster Rd, Dallas, TX 75241-5713 | 2017-10-03 |
| 1245754381 | Sharon Denise Gamble King | Assisted Living Facility | 7412 Lake June Rd, Dallas, TX 75217-1644 | 2017-07-31 |
| 1235681594 | Mason's Personal Care Homes #2 | Assisted Living Facility | 10451 Summer Oaks Dr, Dallas, TX 75227-7681 | 2016-11-02 |
| 1285187559 | Morning Starr New Beginnings | Assisted Living Facility | 9016 Tampas Ln, Dallas, TX 75227-5216 | 2016-08-03 |
| 1134580533 | Sp Alf Ops Co, LLC | Assisted Living Facility | 3922 Simpson Street, Dallas, TX 75246 | 2016-03-11 |
| 1649644972 | C.e.yates Enterprises LLC | Assisted Living Facility | 7822 Red Spring Rd, Dallas, TX 75241-5353 | 2015-11-24 |
| Find all providers in DALLAS | ||||
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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.