CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY (NPI# 1023407012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023407012 |
| Entity Type | Organization |
| Organization Name | CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY |
| Other Organization Name | FT WORTH SOUTHWEST NURSING CENTER |
| Practice Address |
5300 Altamesa Blvd Fort Worth TX 76133-5924 |
| Practice Telephone | 8173461800 |
| Practice Fax Number | 8173460149 |
| Mailing Telephone | 8173461800 |
| Mailing Fax Number | 8173460149 |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2015-03-05 |
| Authorized Official Name | DAVID K BYROM (CEO) |
| Authorized Official Telephone | 2542486300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 005197 | 05 |
| Other Name | Type Code |
|---|---|
| FT WORTH SOUTHWEST NURSING CENTER | 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 |
5300 ALTAMESA BLVD |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76133-5924 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386837680 | Amanda Marie Hill | Speech-Language Pathologist | 5300 Altamesa Blvd, Fort Worth, TX 76133-5924 | 2007-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740830645 | Dieseru Healthcare Services LLC. | Technician | 2325 Woodmont Trail, Forth Worth, TX 76133 | 2019-09-13 |
| 1447636212 | Westcreek Animal Clinic P.C. | Veterinarian | 3313 Park Lake Dr., Fort Worth, TX 76133 | 2015-08-04 |
| 1750784286 | Tlc Dentistry of Fort Worth, LLC | Dentist | 7664 Mccart Ave., Fort Worth, TX 76133 | 2014-09-29 |
| 1184047581 | Jene Hunt | Pharmacist | 6225 Westcreek Dr, Fort Worth, TX 76133 | 2014-01-22 |
| 1841538972 | Chelsea Rene Sanders | Speech-Language Pathologist | 6036 Worrell Dr, Fort Worth, TX 76133 | 2013-01-24 |
| 1588926026 | Roger Allan Beck | Internal Medicine | 4509 Fox Fire Way, Fort Worth, TX 76133 | 2012-06-11 |
| 1477812857 | Little Star Rehab | Point of Service | 4525 Altamesa Blvd, Fort Worth, TX 76133 | 2012-05-07 |
| 1477824605 | Lauren Elizabeth Hall | Speech-Language Pathologist | 5316 Trail Lake Drive, Fort Worth, TX 76133 | 2012-01-19 |
| 1770772519 | Sherriann Michelle Erby | Occupational Therapist | 7100 Trail Lake Drive, Fort Worth, TX 76133 | 2007-10-17 |
| 1811193170 | Carol Diane Edley | Speech-Language Pathologist | 4400 Sweetgum Way, Ft Worth, TX 76133 | 2007-06-25 |
| Find all providers in zip 76133 | ||||
| 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 | 76133 |
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.