FOURSQUARE TEXAS 16, LLC (NPI# 1790236198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790236198 |
| Entity Type | Organization |
| Organization Name | FOURSQUARE TEXAS 16, LLC |
| Other Organization Name | ASHTON MEDICAL LODGE |
| Practice Address |
801 South Loop 250 West Midland TX 79703 |
| Mailing Address |
4311 Oak Lawn Ave Suite 400 Dallas TX 75219-2315 |
| Practice Telephone | 4326892100 |
| Mailing Telephone | 9723037500 |
| Mailing Fax Number | 9723039700 |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2016-10-20 |
| Authorized Official Name | SHANE DELBERT LEWIS (VP/CFO) |
| Authorized Official Telephone | 9723037500 |
| 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 |
|---|---|
| Ashton Medical Lodge | Doing Business As Name - Organization |
| Street Address |
801 SOUTH LOOP 250 WEST |
| City | MIDLAND |
| State | TX |
| Zip Code | 79703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669953022 | Gerardo Calderon | Physical Therapy Assistant | 801 South Loop 250 West, Midland, TX 79703 | 2018-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124637160 | Rachel Murphy | Dietitian, Registered | 4214 Andrews Highway, Suite 107, Midland, TX 79703 | 2020-07-27 |
| 1740819994 | Hunter Occupational Solution | Clinic/Center | 4311 Andrews Hwy., Midland, TX 79703 | 2020-04-08 |
| 1467920413 | Megan Boxberger | Physical Therapy Assistant | 2501 W Illinois, Midland, TX 79703 | 2018-11-07 |
| 1982186219 | Veronica Yero | Occupational Therapy Assistant | 800 Beal Pkwy, Midland, TX 79703 | 2018-09-04 |
| 1801304480 | Alyssa Wennerlind | Counselor | 3701 Andrews Hwy., Midland, TX 79703 | 2018-01-17 |
| 1447797014 | Dickerson Dallas Pain On Pa | Specialist | 4311 Andrews Hwy, Midland, TX 79703 | 2017-01-20 |
| 1578974754 | West Texas Endocrinology & Diabetes Pa | Internal Medicine | 3305 Andrews Hwy Ste B1, Midland, TX 79703 | 2014-05-09 |
| 1295969699 | Ramakrishna Thokala | Internal Medicine | 3302 W Golf Course Rd Ste 100, Midland, TX 79703 | 2009-05-13 |
| 1699959569 | City of Midland | Public Health or Welfare | 3303 W Illinois, Sp 22, Midland, TX 79703 | 2007-12-27 |
| 1609973502 | Dale L Mansfield | Chiropractor | 4107 W Illinois, Midland, TX 79703 | 2006-09-20 |
| Find all providers in zip 79703 | ||||
| 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 |
|---|---|---|---|---|
| 1558737965 | Visions Senior Care Corporation | Skilled Nursing Facility | 3121 Roosevelt Ave, Midland, TX 79701-6739 | 2015-08-19 |
| 1639353881 | Serenity Meadows Care Center Corporation | Skilled Nursing Facility | 2300 Camp Dr, Apt 1103, Midland, TX 79701-2005 | 2007-12-24 |
| 1790979623 | Legend Healthcare Midland, LLC | Skilled Nursing Facility | 3000 Mockingbird, Midland, TX 79705-1608 | 2007-09-04 |
| 1003913773 | Trinity Haven Healthcare Center, Inc. | Skilled Nursing Facility | 3203 Sage St, Midland, TX 79705-5711 | 2006-09-17 |
| 1487767026 | Midmichigan Stratford Village | Skilled Nursing Facility | 2121 Rockwell Drive, Midland, MI 48642-9316 | 2006-08-17 |
| 1679518377 | Tendercare (michigan) Inc. | Skilled Nursing Facility | 4900 Hedgewood Dr, Midland, MI 48640-1928 | 2006-06-17 |
| 1124014998 | Terrace West Nursing and Rehabilitation Lp | Skilled Nursing Facility | 2800 N Midland Dr, Midland, TX 79707-5536 | 2005-09-27 |
| 1710984117 | Midland Nursing Center LLC | Skilled Nursing Facility | 3615 E Ashman Rd, Midland, MI 48642-8858 | 2005-06-30 |
| 1588122238 | Anson Hospital District | Skilled Nursing Facility | 3000 Mockingbird, Midland, TX 79705-1608 | 2019-03-12 |
| 1790201911 | Fpacp Hogan Park LLC | Skilled Nursing Facility | 3203 Sage St, Midland, TX 79705-5711 | 2017-08-18 |
| Find all providers in MIDLAND | ||||
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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.