FIRESIDE LODGE RETIREMENT CENTER INC (NPI# 1962423871) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962423871 |
| Entity Type | Organization |
| Organization Name | FIRESIDE LODGE RETIREMENT CENTER INC |
| Practice Address |
4800 White Settlement Rd Ft Worth TX 76114-3955 |
| Practice Telephone | 8177386556 |
| Practice Fax Number | 8177386559 |
| Mailing Telephone | 8177386556 |
| Mailing Fax Number | 8177386559 |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. TERRY MCGRATH JR. (OWNER) |
| Authorized Official Telephone | 8177386556 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 117321 | TX | Nursing & Custodial Care Facilities |
| Street Address |
4800 WHITE SETTLEMENT RD |
| City | FT WORTH |
| State | TX |
| Zip Code | 76114-3955 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952917957 | Jennie Bauchert | Massage Therapist | 1205 Roaring Springs Rd., Ft Worth, TX 76114 | 2020-09-16 |
| 1417438243 | North Texas Area Community Health Centers, Inc | Pharmacy | 2332 Beverly Hills Drive Ste 1116, Ft. Worth, TX 76114 | 2018-08-29 |
| 1023525573 | Jennifer Christine Arriaga | Occupational Therapy Assistant | 125 Smallwood, Fort Worth, TX 76114 | 2018-01-05 |
| 1831617216 | Kailene Allis | Specialist/Technologist | 5519 Norte Dame Ave, River Oaks, TX 76114 | 2017-09-06 |
| 1336662022 | Ben Luka | Dentist | 639 Alta Mere Dr, Fort Worth, TX 76114 | 2017-07-25 |
| 1750771382 | Signature Family Dentistry Pllc | Dentist | 4839 River Oaks Blvd., River Oaks, TX 76114 | 2015-02-04 |
| 1447668223 | Wal-mart Stores Texas, LLC | Technician/Technologist | 2245 Jacksonboro Hwy, Ft. Worth, TX 76114 | 2014-07-24 |
| 1558611897 | Walgreens | Pharmacist | 5716 Aton Ave, Westworth Village, TX 76114 | 2012-09-13 |
| 1437439551 | Ashley Kristen Murrey | Dentist | 6628 Westworth Blvd, Westworth Village, TX 76114 | 2011-08-20 |
| 1598054637 | Ashley Anne Trabon | Physician Assistant | 4819 River Oaks, Fort Worth, TX 76114 | 2011-03-29 |
| Find all providers in zip 76114 | ||||
| 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 |
|---|---|---|---|---|
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| 1811018476 | Ssc Fort Worth Downtown Operating Company LLC | Skilled Nursing Facility | 424 S Adams St, Ft Worth, TX 76104-1003 | 2007-04-02 |
| 1508885658 | Stonegate Nursing Center Ltd | Skilled Nursing Facility | 4201 Stonegate Blvd, Ft Worth, TX 76109-9503 | 2006-07-19 |
| 1902278732 | Stonegate Scc LLC | Skilled Nursing Facility | 4201 Stonegate Blvd, Ft Worth, TX 76109-9503 | 2015-10-20 |
| 1285037259 | Eastland Nursing Operations, LLC | Skilled Nursing Facility | 306 W 7th St, Ft Worth, TX 76102-4900 | 2014-10-03 |
| 1053725838 | Pecos Nursing Opertaions, LLC | Skilled Nursing Facility | 306 W 7th St, Suite 430, Ft Worth, TX 76102-4900 | 2014-06-19 |
| 1568891174 | Swc Fort Worth Operating Company LLC | Skilled Nursing Facility | 8001 Western Hills Blvd, Ft Worth, TX 76108-3524 | 2013-11-04 |
| 1427398726 | Iowa Park Nursing Operations, LLC | Skilled Nursing Facility | 306 W 7th St Ste 430, Ft Worth, TX 76102-4902 | 2013-02-22 |
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| 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 |
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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.