MEADOW CREEK SCC LLC (NPI# 1336577873) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336577873 |
| Entity Type | Organization |
| Organization Name | MEADOW CREEK SCC LLC |
| Other Organization Name | SENIOR CARE OF MEADOW CREEK |
| Practice Address |
4343 Oak Grove Blvd. San Angelo TX 76904-4500 |
| Mailing Address |
600 N Pearl St Ste 1050 Dallas TX 75201-7495 |
| Practice Telephone | 3259492559 |
| Practice Fax Number | 3259493598 |
| Mailing Telephone | 2142527600 |
| Mailing Fax Number | 2142527704 |
| Enumeration Date | 2013-10-18 |
| Last Update Date | 2020-03-04 |
| Authorized Official Name | MICHAEL BEAL (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2142527600 |
| 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 | 001025585 | 05 |
| Other Name | Type Code |
|---|---|
| Senior Care of Meadow Creek | Doing Business As Name - Organization |
| Street Address |
4343 OAK GROVE BLVD. |
| City | SAN ANGELO |
| State | TX |
| Zip Code | 76904-4500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720623622 | Stratford Hospital District | Skilled Nursing Facility | 4343 Oak Grove Blvd., San Angelo, TX 76904 | 2019-11-14 |
| 1376024331 | Jesi Leann Backlund | Occupational Therapist | 4343 Oak Grove Blvd., San Angelo, TX 76904-4500 | 2018-08-27 |
| 1932585809 | Bethany Dawn Shannon | Occupational Therapy Assistant | 4343 Oak Grove Blvd., San Angelo, TX 76904 | 2015-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407342702 | Mark Wandal Duncan | Specialist/Technologist | 2237 South Jackson, San Angelo, TX 76904 | 2018-07-10 |
| 1700267259 | Sheila Patterson | Nurse Practitioner | 4251 Sunset Drive, San Angelo, TX 76904 | 2015-06-10 |
| 1346649316 | Mason William Mcclintock | Dentist | 2402 College Hills Blvd. Building 1, Building 1, San Angelo, TX 76904 | 2014-08-15 |
| 1265855712 | Lynn M. Thebo, Lcsw, Pllc | Social Worker | 3109 Southwest Blvd. Ste. B, San Angelo, TX 76904 | 2014-02-03 |
| 1487077459 | Lynn Marie Thebo | Social Worker | 3109 Southwest Blvd., Ste. B, San Angelo, TX 76904 | 2014-01-28 |
| 1558646521 | John Porter Parker Jr. | Pharmacist | 3705 Threewn Trail, San Angelo, TX 76904 | 2011-10-20 |
| 1568772036 | Medical Alliance Group of Texas, LLC | Durable Medical Equipment & Medical Supplies | 2525 S Johnson Ste A, San Angelo, TX 76904 | 2010-10-18 |
| 1578796710 | Jennifer L White | Physical Therapist | 2237 S. Jackson, San Angelo, TX 76904 | 2009-09-03 |
| 1548443203 | Kelly K. Sawyer, D.d.s., P.a. | Dentist | 3013 W. Loop 306, San Angelo, TX 76904 | 2007-12-17 |
| 1023224789 | D&s Residential Services | Intermediate Care Facility, Mentally Retarded | 1706 Idaho Avenue, San Angelo, TX 76904 | 2007-05-16 |
| Find all providers in zip 76904 | ||||
| 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 |
|---|---|---|---|---|
| 1972663813 | Pm Management-san Angelo Nc I LLC | Skilled Nursing Facility | 4343 Oak Grove Blvd, San Angelo, TX 76904-4550 | 2006-12-11 |
| 1104986041 | Pm Management-san Angelo Nc II LLC | Skilled Nursing Facility | 3745 Summer Crest Dr, San Angelo, TX 76901-9782 | 2006-12-11 |
| 1720003536 | Legend Oaks - San Angelo, LLC | Skilled Nursing Facility | 5455 Knickerbocker Rd, San Angelo, TX 76904-7711 | 2006-07-13 |
| 1306875281 | Seminole Hospital District | Skilled Nursing Facility | 902 North Main Street, San Angelo, TX 76903-4077 | 2006-07-02 |
| 1588643761 | Cedar Manor Nursing & Rehab Center, LLC | Skilled Nursing Facility | 1915 Greenwood St, San Angelo, TX 76901-1112 | 2006-01-16 |
| 1215925920 | Stratford Hospital District | Skilled Nursing Facility | 609 Rio Concho Dr, San Angelo, TX 76903-6029 | 2005-10-07 |
| 1720623622 | Stratford Hospital District | Skilled Nursing Facility | 4343 Oak Grove Blvd., San Angelo, TX 76904 | 2019-11-14 |
| 1811532401 | Stratford Hospital District | Skilled Nursing Facility | 3745 Summer Crest Dr, San Angelo, TX 76901-9782 | 2019-11-07 |
| 1770042384 | Regency Ihs of San Angelo LLC San Angelo Nursing and Rehab | Skilled Nursing Facility | 5455 Knickerbocker Rd, San Angelo, TX 76904-7711 | 2019-03-14 |
| 1023576774 | Anson Hospital District | Skilled Nursing Facility | 5455 Knickerbocker Rd, San Angelo, TX 76904-7711 | 2019-03-12 |
| Find all providers in SAN ANGELO | ||||
| City | SAN ANGELO |
| Zip Code | 76904 |
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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.