FANNIN COUNTY HOSPITAL AUTHORITY (NPI# 1124495486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124495486 |
| Entity Type | Organization |
| Organization Name | FANNIN COUNTY HOSPITAL AUTHORITY |
| Other Organization Name | MAGNOLIA PLACE SKILLED NURSING AND REHAB |
| Practice Address |
1307 Martin Luther King Dr Jefferson TX 75657-1009 |
| Mailing Address |
504 Lipscomb St Bonham TX 75418-4028 |
| Practice Telephone | 9036653951 |
| Mailing Telephone | 9035838585 |
| Enumeration Date | 2015-08-21 |
| Last Update Date | 2020-07-17 |
| Authorized Official Name | CLARK SANDERSON (PRESIDENT) |
| Authorized Official Telephone | 9035831854 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | TX | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 1029296 | 05 |
| Other Name | Type Code |
|---|---|
| Magnolia Place Skilled Nursing and Rehab | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619474293 | Fannin County Hospital Authority | Surgery | 1211 E 6th St Ste 120, Bonham, TX 75418 | 2018-04-10 |
| 1578911384 | Fannin County Hospital Authority | Skilled Nursing Facility | 16550 Retama Parkway, Selma, TX 78154 | 2016-06-02 |
| 1902163686 | Fannin County Hospital Authority | Skilled Nursing Facility | 2900 Stillhouse Rd, Paris, TX 75462-2029 | 2012-04-18 |
| 1316270267 | Fannin County Hospital Authority | Skilled Nursing Facility | 721 S Hwy 78, Wylie, TX 75098-4004 | 2009-09-10 |
| 1568695310 | Fannin County Hospital Authority | Preventive Medicine | 505 Lipscomb Blvd, Bonham, TX 75418-4027 | 2009-08-27 |
| 1649402603 | Fannin County Hospital Authority | Skilled Nursing Facility | 2265 S Sycamore St, Palestine, TX 75801-4774 | 2009-08-10 |
| 1710008263 | Fannin County Hospital Authority | Skilled Nursing Facility | 711 Lucas Dr, Athens, TX 75751-3445 | 2007-04-03 |
| 1770604365 | Fannin County Hospital Authority | Skilled Nursing Facility | 8383 Meadow Rd, Dallas, TX 75231-3701 | 2007-04-02 |
| 1801917497 | Fannin County Hospital Authority | Skilled Nursing Facility | 4825 Wellesley Ave, Fort Worth, TX 76107-6148 | 2007-04-02 |
| 1477674968 | Fannin County Hospital Authority | Skilled Nursing Facility | 2645 W Randol Mill Rd, Arlington, TX 76012-4228 | 2007-04-02 |
| Street Address |
1307 MARTIN LUTHER KING DR |
| City | JEFFERSON |
| State | TX |
| Zip Code | 75657-1009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952397739 | Pine Hill Nursing and Rehabilitation Lp | Skilled Nursing Facility | 1307 Martin Luther King Dr, Jefferson, TX 75657-1009 | 2005-09-27 |
| 1598910291 | Jefferson I Enterprises, LLC | Skilled Nursing Facility | 1307 Martin Luther King Dr, Jefferson, TX 75657-1009 | 2008-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780131995 | Kimberly George | Case Manager/Care Coordinator | 261 Ma County Road 3430, Jefferson, TX 75657 | 2016-09-06 |
| 1124116561 | The Med Shop | Durable Medical Equipment & Medical Supplies | 110 N . Walnut, Jefferson, TX 75657 | 2006-10-11 |
| 1487644068 | Denise Sepulvado Norris | Occupational Therapist | 1404 Marion County Road 3509, Jefferson, TX 75657 | 2005-10-25 |
| 1700870185 | Robin Lynne Gale | Nurse Practitioner | 219 N Polk St, Jefferson, TX 75657 | 2005-08-31 |
| 1700072477 | James Leo Carroll | Physical Therapy Assistant | 339 Tangiers, Jefferson, TX 75657-0598 | 2007-09-17 |
| 1558404293 | Jefferson Isd | Local Education Agency (LEA) | 1600 Martin Luther King Dr, Jefferson, TX 75657-1061 | 2007-02-14 |
| 1730352667 | Demetria Rena Parker | Nurse's Aide | 506 E Harrison St, Jefferson, TX 75657-1106 | 2008-04-11 |
| 1114985876 | Good Shepherd Medical Center - Linden, Inc | Clinic/Center | 903 N Walcott St, Jefferson, TX 75657-1128 | 2006-05-03 |
| 1205953130 | William Louis Castleman | Massage Therapist | 903 N Walcott St, Jefferson, TX 75657-1128 | 2007-03-24 |
| 1992887657 | Cypress Place Assisted Living | Assisted Living Facility | 100 W Douglas St, Jefferson, TX 75657-1206 | 2006-10-20 |
| Find all providers in zip 75657 | ||||
| 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 |
|---|---|---|---|---|
| 1669711735 | Mark Bordeaux | Skilled Nursing Facility | Margate Health and Rehab 540 Waugh St, Jefferson, NC 28640-9034 | 2013-02-08 |
| 1962505313 | Margate Health and Rehab Center LLC | Skilled Nursing Facility | 540 Waugh Street, Jefferson, NC 28640-0130 | 2006-09-07 |
| 1487692380 | Jefferson Healthcare Center LLC | Skilled Nursing Facility | 2200 Jefferson Hwy, Jefferson, LA 70121-3822 | 2006-06-03 |
| 1477513059 | Centers for Long Term Care of Iowa | Skilled Nursing Facility | 100 Ram Dr, Jefferson, IA 50129-2728 | 2006-03-27 |
| 1952397739 | Pine Hill Nursing and Rehabilitation Lp | Skilled Nursing Facility | 1307 Martin Luther King Dr, Jefferson, TX 75657-1009 | 2005-09-27 |
| 1801881420 | Jefferson Health Center | Skilled Nursing Facility | 222 E Beech St, Jefferson, OH 44047-9490 | 2005-09-20 |
| 1346872413 | Opco Jefferson, Ia, LLC | Skilled Nursing Facility | 100 Ram Dr, Jefferson, IA 50129-2728 | 2020-02-06 |
| 1285958298 | Alden Estates of Countryside, Inc. | Skilled Nursing Facility | 1130 Collins Rd, Jefferson, WI 53549-2939 | 2010-03-19 |
| 1598910291 | Jefferson I Enterprises, LLC | Skilled Nursing Facility | 1307 Martin Luther King Dr, Jefferson, TX 75657-1009 | 2008-11-21 |
| 1639379902 | Magnolia Manor Management Inc | Skilled Nursing Facility | 510 E Bonham St, Jefferson, TX 75657-1506 | 2007-07-24 |
| Find all providers in JEFFERSON | ||||
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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.