FOURSQUARE TEXAS 16 LLC (NPI# 1851849897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851849897 |
| Entity Type | Organization |
| Organization Name | FOURSQUARE TEXAS 16 LLC |
| Other Organization Name | SHERIDAN MEDICAL LODGE |
| Practice Address |
1119 S. Red River Expressway Burkburnett TX 76354 |
| Mailing Address |
4311 Oak Lawn Suite 400 Dallas TX 75219 |
| Practice Telephone | 9405699500 |
| Mailing Telephone | 9723037500 |
| Mailing Fax Number | 9723039700 |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2017-05-04 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 001028346 | 05 |
| Other Name | Type Code |
|---|---|
| Sheridan Medical Lodge | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205478286 | Foursquare Texas 16 LLC | Skilled Nursing Facility | 1401 W. Princeton Dr., Princeton, TX 75407 | 2019-10-11 |
| 1851857304 | Foursquare Texas 16 LLC | Skilled Nursing Facility | 750 Highway 352, Mesquite, TX 75149 | 2019-02-20 |
| Street Address |
1119 S. RED RIVER EXPRESSWAY |
| City | BURKBURNETT |
| State | TX |
| Zip Code | 76354 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861024341 | Kaytlynn Flowers | Pharmacy Technician | 514 South Oklahoma Cutoff, Burkburnett, TX 76354 | 2020-02-12 |
| 1760983597 | Britney Sims | Licensed Vocational Nurse | 703 Meadow Dr, Burkburnett, TX 76354 | 2018-02-27 |
| 1669929741 | Burk Smiles Pllc | Dentist | 412 B South Ave D, Burkburnett, TX 76354 | 2016-09-06 |
| 1902004112 | Fikes Boomtown Drug | Pharmacy | 514 S. Oklahoma Cutoff, Burkburnett, TX 76354 | 2007-07-10 |
| 1396842951 | Christopher Kevin Wyatt | Psychiatry & Neurology | 312 S Avenue D, Burkburnett, TX 76354 | 2006-09-17 |
| 1821645151 | Bryan William Harrison | Pharmacist | 514 S. Oklahoma Cutoff, Burkburnett, TX 76354 | 2019-08-21 |
| 1730603978 | Kelly Lynn Hall | Physician Assistant | 149 Hart St, 82nd Mdos/sgop Family Practice, Sheppard Afb, TX 76354 | 2017-07-31 |
| 1548460801 | Fikes Boomtown Drug, Inc. | Durable Medical Equipment & Medical Supplies | 514 S. Oklahoma Cutoff, Burkburnett, TX 76354 | 2007-07-24 |
| 1497219943 | Allen Wayne Durbin Jr. | Physical Therapy Assistant | 507 E 5th St, Burkburnett, TX 76354-1607 | 2019-01-29 |
| 1588652051 | Evergreen Healthcare Center | Nursing Facility/Intermediate Care Facility | 406 E 7th St, Burkburnett, TX 76354-2017 | 2005-10-10 |
| Find all providers in zip 76354 | ||||
| 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 |
|---|---|---|---|---|
| 1780618835 | Nocona Hospital District | Skilled Nursing Facility | 406 E 7th St, Burkburnett, TX 76354-2017 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285233171 | Center At Zaragoza, LLC | Skilled Nursing Facility | 12660 Pebble Hills Blvd., El Paso, TX 79936 | 2020-10-21 |
| 1609473362 | Touchstone Strategies - Penitas, LLC | Skilled Nursing Facility | 414 Liberty Blvd., Penitas, TX 78576 | 2020-10-06 |
| 1649884313 | Springtown Ventures Lp | Skilled Nursing Facility | 201 Williams Ward Rd., Springtown, TX 76082 | 2020-09-01 |
| 1821601691 | Altamira Healthcare LLC | Skilled Nursing Facility | 200 Carla St, Zapata, TX 78076-3114 | 2020-08-31 |
| 1538770839 | Go Operations 3 LLC | Skilled Nursing Facility | 4366 Lockhill Selma, Shavano, TX 78249 | 2020-08-11 |
| 1912516329 | Patriot Skilled Nursing and Rehabilitation LLC | Skilled Nursing Facility | 11490 Gateway N Blvd., El Paso, TX 79934 | 2020-07-31 |
| 1972112464 | The Brixton At Horseshoe Bay | Skilled Nursing Facility | 15101 West Fm 2147, Horseshoe Bay, TX 78657 | 2020-07-30 |
| 1558984278 | Slp Johnson City LLC | Skilled Nursing Facility | 206 Haley Rd, Johnson City, TX 78636-4617 | 2020-05-28 |
| 1073136149 | Continuum Rehab Group | Skilled Nursing Facility | 3326 Burgoyne St # 1432, Dallas, TX 75233-1304 | 2020-05-24 |
| 1750904264 | Frank Villanueva | Skilled Nursing Facility | 711 W Broadway St, Denver City, TX 79323-3000 | 2020-05-19 |
| Find all providers with the same taxonomy | ||||
| City | BURKBURNETT |
| Zip Code | 76354 |
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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.