CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY (NPI# 1962891523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962891523 |
| Entity Type | Organization |
| Organization Name | CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY |
| Other Organization Name | BRENTWOOD PLACE IV |
| Practice Address |
3505 S Buckner Blvd Bldg 5 Dallas TX 75227-5451 |
| Practice Telephone | 2143811815 |
| Practice Fax Number | 2142757618 |
| Mailing Telephone | 2143811815 |
| Mailing Fax Number | 2142757618 |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2015-01-20 |
| Authorized Official Name | DAVID K BYROM (CEO) |
| Authorized Official Telephone | 2542486300 |
| 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 | 104549 | 05 |
| Other Name | Type Code |
|---|---|
| BRENTWOOD PLACE IV | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780298547 | Coryell County Memorial Hospital Authority | Clinic/Center | 498 Avenue E, Moody, TX 76557-3579 | 2020-08-31 |
| 1780124594 | Coryell County Memorial Hospital Authority | Skilled Nursing Facility | 121 Commons, Athens, TX 75751-0009 | 2017-02-27 |
| 1952531824 | Coryell County Memorial Hospital Authority | Family Medicine | 3401 East Main Street, Gatesville, TX 76528-1028 | 2009-07-24 |
| 1457468431 | Coryell County Memorial Hospital Authority | Skilled Nursing Facility | 7801 Woodway Dr, Woodway, TX 76712-3860 | 2006-08-24 |
| 1669589610 | Coryell County Memorial Hospital Authority | Skilled Nursing Facility | 8501 Laurens Ln, San Antonio, TX 78218-6092 | 2006-08-24 |
| 1447296264 | Coryell County Memorial Hospital Authority | Nursing Facility/Intermediate Care Facility | 110 Chicktown Road, Gatesville, TX 76528-1035 | 2006-06-21 |
| 1518900778 | Coryell County Memorial Hospital Authority | Clinic/Center | 1510 Hannah Valley Rd, Goldthwaite, TX 76844-2533 | 2006-06-14 |
| 1568417491 | Coryell County Memorial Hospital Authority | Emergency Medicine | 1507 West Main Street, Gatesville, TX 76528-1024 | 2006-05-22 |
| 1538624507 | Coryell County Memorial Hospital Authority | Skilled Nursing Facility | 2300 S Oak Grove Rd, Ennis, TX 75119-6841 | 2019-02-04 |
| 1649760877 | Coryell County Memorial Hospital Authority | Skilled Nursing Facility | 7625 Glenview Dr, Richland Hills, TX 76180-8331 | 2018-05-14 |
| Street Address |
3505 S BUCKNER BLVD BLDG 5 |
| City | DALLAS |
| State | TX |
| Zip Code | 75227-5451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760855464 | Narges S Afkami | Chiropractor | 4808 S. Buckner Blvd., Dallas, TX 75227 | 2015-11-04 |
| 1780902809 | Zachary Thomas Ripp | Obstetrics & Gynecology | 2959 S. Buckner Ste 100, Mi Doctor/ Women's Specialty Center, Dallas, TX 75227 | 2010-05-13 |
| 1386884922 | Valentino L Gonzales | Counselor | 5409 Jim Miller Rd, Suite 203a, Dallas, TX 75227 | 2009-02-23 |
| 1093951733 | Kofo A Aderemi | Durable Medical Equipment & Medical Supplies | 4617 S. Buckner Blvd., Suite J, Dallas, TX 75227 | 2008-12-31 |
| 1619146727 | Faith Assisted Living, LLC | Assisted Living Facility | 2155 Gaylord Dr, Dallas, TX 75227 | 2008-02-22 |
| 1619159241 | Epic Business Solutions | Durable Medical Equipment & Medical Supplies | 4801 South Buckner Blvd., Suite 1300, Dallas, TX 75227 | 2007-12-05 |
| 1356553838 | Cox Adult Foster Home | Custodial Care Facility | 8717 Blossom Lane, Dallas, TX 75227 | 2007-05-04 |
| 1386866903 | Injury Assistance C Enters, Inc. | Chiropractor | 2514 S. Buckner Blvd., Dallas, TX 75227 | 2007-05-03 |
| 1083836613 | Fiesta Pharmacy | Pharmacist | 2947 S Buckner Suite 500, Dallas, TX 75227 | 2007-05-03 |
| 1720164346 | Joe R Gosham | Dentist | 2222 Prairie Creek Rd, Dallas, TX 75227 | 2006-10-27 |
| Find all providers in zip 75227 | ||||
| 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 |
|---|---|---|---|---|
| 1073136149 | Continuum Rehab Group | Skilled Nursing Facility | 3326 Burgoyne St # 1432, Dallas, TX 75233-1304 | 2020-05-24 |
| 1013546118 | The Legacy Midtown Park, Inc | Skilled Nursing Facility | 8280 Manderville Lane, Dallas, TX 75231 | 2020-04-02 |
| 1508325275 | Buckner Senior Living, Inc. | Skilled Nursing Facility | One Ventana Way, 8301 N Central Expressway, Dallas, TX 75225 | 2019-03-13 |
| 1437625092 | Le Reve Rehab & Mc LLC | Skilled Nursing Facility | 3309 Dilido Road, Dallas, TX 75228 | 2018-10-22 |
| 1740710094 | Adora 9 Operations, LLC | Skilled Nursing Facility | 8130 Meadow Road, Dallas, TX 75231 | 2017-06-19 |
| 1346678398 | The Rehabilitation & Wellness Centre of Dallas, LLC | Skilled Nursing Facility | 4200 Live Oak St, Dallas, TX 75204-6733 | 2013-10-29 |
| 1639428972 | Riverwood Healthcare LLC | Skilled Nursing Facility | 9009 Forest Lane, Dallas, TX 75243 | 2012-08-31 |
| 1013265446 | Remarkable Healthcare of Dallas, Lp | Skilled Nursing Facility | 3350 Bonnie View Road, Dallas, TX 75216 | 2012-08-15 |
| 1558620633 | Highland Springs, Inc | Skilled Nursing Facility | 7910 Frankford Rd, Attn: Extended Care Administrator, Dallas, TX 75252-6865 | 2012-05-10 |
| 1124385000 | Reliant Lakeside Holdings LLC | Skilled Nursing Facility | Rr 4 Box 357, Dallas, PA 18612-9236 | 2012-04-18 |
| Find all providers in DALLAS | ||||
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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.