SOUTHWEST LTC - BONNER LLC


Address: 810 Bellaire St, Jacksonville, TX 75766-9045
Phone: 9035895300

SOUTHWEST LTC - BONNER LLC (NPI# 1033772413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1033772413
Entity Type Organization
Organization Name SOUTHWEST LTC - BONNER LLC
Practice Address 810 Bellaire St
Jacksonville
TX 75766-9045
Mailing Address 5560 Tennyson Pkwy Ste 210
Plano
TX 75024-3582
Practice Telephone 9035895300
Mailing Telephone 4699166100
Enumeration Date 2019-04-21
Last Update Date 2019-04-21
Authorized Official Name RONALD PAYNE (PRESIDENT)
Authorized Official Telephone 4699166100
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 314000000X Skilled Nursing Facility Nursing & Custodial Care Facilities

Other Provider/Organization Names

Other Name Type Code
Legacy at Jacksonville Doing Business As Name - Organization

Office Location

Street Address 810 BELLAIRE ST
City JACKSONVILLE
State TX
Zip Code 75766-9045

Providers in the same location

NPI Name Taxonomy Address Enumeration
1689993032 Jacksonville Scc, LLC Skilled Nursing Facility 810 Bellaire St, Jacksonville, TX 75766-9045 2010-05-25
1417430042 Christy Michelle Spell Occupational Therapy Assistant 810 Bellaire St, Jacksonville, TX 75766-9045 2018-09-10
1992286710 Jordan Victoria Smith Occupational Therapy Assistant 810 Bellaire St, Jacksonville, TX 75766-9045 2018-08-29
1699256651 Dayna Faith Mckey Physical Therapy Assistant 810 Bellaire St, Jacksonville, TX 75766-9045 2018-08-27
1831670017 Virginia S Lotito Speech-Language Pathologist 810 Bellaire St, Jacksonville, TX 75766-9045 2018-08-24
1477033231 Matthew Goldman Physical Therapy Assistant 810 Bellaire St, Jacksonville, TX 75766-9045 2018-08-20
1861972937 Alaina Paige Newman Clinical Exercise Physiologist 810 Bellaire St, Jacksonville, TX 75766-9045 2018-08-18
1093131476 Nacogdoches County Hospital District Skilled Nursing Facility 810 Bellaire St, Jacksonville, TX 75766-9045 2014-03-10
1588935605 Clair Johanna Radliff Physical Therapy Assistant 810 Bellaire St, Jacksonville, TX 75766-9045 2012-01-20

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1770062788 David Rentz Occupational Therapy Assistant 838 Brown St., Jacksonville, TX 75766 2018-08-09
1295233146 Amanda Dawn Anderson Licensed Vocational Nurse Fm 347, Jacksonville, TX 75766 2018-01-25
1467896241 Christopher Mark Sirianni Anesthesiology 2026 S Jackson St Apt 1213, Jacksonville, TX 75766 2013-04-23
1164703047 Aegis Psychological Consulting LLC Psychologist 208 E. Rusk St., Jacksonville, TX 75766 2011-09-06
1952697872 Melissa Springmeyer Family Medicine 2026 South Jacksonville Street, Jacksonville, TX 75766 2011-06-20
1306031018 Michael Kay Moore Occupational Therapist 4155 Cr 3908, Jacksonville, TX 75766 2007-09-06
1730398827 Cherokee County Health Department Public Health or Welfare 510 East Commerce, Jacksonville, TX 75766 2007-05-22
1568689545 Mary Alice Bone Preventive Medicine 510 E. Commerce, Jacksonville, TX 75766 2007-04-19
1619093176 Assisted Living Concepts Inc Assisted Living Facility 211 Phillip Street, Jacksonville, TX 75766 2007-03-22
1265560767 Anderson Cherokee Community Enrichment Services Counselor 1011 College Ave, Jacksonville, TX 75766 2007-02-28
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Taxonomy Information

Taxonomy Code 314000000X
Grouping Nursing & Custodial Care Facilities
Classification Skilled Nursing Facility

Taxonomy Definition

(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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1578199303 First Coast Health Ventures, LLC Skilled Nursing Facility 15480 Max Leggett Parkway, Jacksonville, FL 32218 2020-03-12
1992336895 Dolphin Pointe Health Care, LLC Skilled Nursing Facility 5355 Dolphin Point Rd., Jacksonville, FL 32211 2020-01-29
1629439260 West Jax Geriatrics, LLC Skilled Nursing Facility 730 College St, Jacksonville, FL 32204-3313 2016-03-10
1376955377 Edwin Bato Skilled Nursing Facility 3434 Nightscape Cir, Jacksonville, FL 32224-1618 2014-05-24
1508138678 Terri Velinda Virgil Skilled Nursing Facility 11555 Birch Forest Circle East, Jacksonville, FL 32218 2012-02-03
1689993032 Jacksonville Scc, LLC Skilled Nursing Facility 810 Bellaire St, Jacksonville, TX 75766-9045 2010-05-25
1326362005 Brooks Skilled Nursing Facility, A, Inc. Skilled Nursing Facility 6209 Brooks Bartram Dr. Bldg 100, Jacksonville, FL 32258 2010-03-24
1144476946 Magnus Opus Technology Skilled Nursing Facility 7000 Northlake Dr, Jacksonville, AR 72076-4959 2008-08-12
1972796175 Russell Wayne Tolliver Skilled Nursing Facility 4083 Sunbeam Rd, Apartment 1409, Jacksonville, FL 32257-8993 2007-08-21
1750409082 Patti Sperling Arnp LLC Skilled Nursing Facility 402 Myrtlewood Cir, Jacksonville, NC 28546-7412 2007-03-26
Find all providers in JACKSONVILLE

Competitor

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City JACKSONVILLE
Zip Code 75766

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Dataset Information

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.

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