HSMTX WATERTON PLAZA, LLC (NPI# 1982886578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982886578 |
| Entity Type | Organization |
| Organization Name | HSMTX WATERTON PLAZA, LLC |
| Other Organization Name | THE WATERTON PLAZA SENIOR CARE |
| Practice Address |
2875 Shiloh Rd Tyler TX 75703-2936 |
| Mailing Address |
5300 Hollister St Suite 550 Houston TX 77040-6137 |
| Practice Telephone | 9035611300 |
| Practice Fax Number | 9039391754 |
| Mailing Telephone | 7139347800 |
| Mailing Fax Number | 7138950064 |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2010-02-16 |
| Authorized Official Name | CHARLES A DAVIS (VP FINANCE) |
| Authorized Official Telephone | 7139347800 |
| 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 | 001017767 | 05 |
| Other Name | Type Code |
|---|---|
| The Waterton Plaza Senior Care | Doing Business As Name - Organization |
| Street Address |
2875 SHILOH RD |
| City | TYLER |
| State | TX |
| Zip Code | 75703-2936 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861972903 | Christopher Okon Jr. | Physical Therapy Assistant | 2875 Shiloh Rd, Tyler, TX 75703-2936 | 2018-08-17 |
| 1497234116 | Heidi Mae Cage | Occupational Therapist | 2875 Shiloh Rd, Tyler, TX 75703-2936 | 2018-08-13 |
| 1063991362 | Sarah Colleen Brogan-haan | Physical Therapist | 2875 Shiloh Rd, Tyler, TX 75703-2936 | 2018-08-08 |
| 1871919431 | Memorial Hospital | Skilled Nursing Facility | 2875 Shiloh Rd, Tyler, TX 75703-2936 | 2014-03-06 |
| 1447525803 | East Texas Ltc The Waterton At Shiloh LLC | Skilled Nursing Facility | 2875 Shiloh Rd, Tyler, TX 75703-2936 | 2012-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174155477 | Choice Supportive Care Team Inc. | Family Medicine | 4293 Kinsey Drive, Tyler, TX 75703 | 2020-02-05 |
| 1770052532 | Refinery Chiropractic LLC | Chiropractor | 16637 Old Jacksonville Hwy, Suite D, Tyler, TX 75703 | 2018-11-21 |
| 1215419353 | Deidre Lynn Fergason | Occupational Therapy Assistant | 3505 Old Jacksonville Hwy, Tyler, TX 75703 | 2018-09-05 |
| 1710473681 | Justin Taylor Ross | Dentist | 8938 S Broadway Ave Ste 380, Tyler, TX 75703 | 2018-07-03 |
| 1457843450 | Adam Tyler Barnes, Dds of Texas II, Pllc | Dentist | 8938 South Broadway, Ste 480, Tyler, TX 75703 | 2018-06-05 |
| 1083106462 | Integrity Health | Internal Medicine | 5605 Old Bullard Rd Ste B, Tyler, TX 75703 | 2018-06-01 |
| 1427572544 | Cody Wayne Graham | Pharmacist | 5415 S. Broadway Ave., Tyler, TX 75703 | 2017-07-31 |
| 1750805941 | Roger Bryan Chapman | Nurse Practitioner | 6115 New Copeland Rd, Tyler, TX 75703 | 2017-07-28 |
| 1427570084 | Darah Lynne Dahlem | Speech-Language Pathologist | 401 E. Front Street Ste 123, Tyler, TX 75703 | 2017-07-14 |
| 1194267468 | Herman Lester Hampton Jr. | Surgery | 5803 Regents Row, Tyler, TX 75703 | 2016-11-17 |
| Find all providers in zip 75703 | ||||
| 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 |
|---|---|---|---|---|
| 1396291969 | The Center At Grande, LLC | Skilled Nursing Facility | 3219 East Grande Blvd, Tyler, TX 75707 | 2016-09-01 |
| 1972902245 | Titus County Hospital District | Skilled Nursing Facility | 3505 Old Jacksonvil Rd, Tyler, TX 75701-8510 | 2014-08-22 |
| 1104249317 | Rehab Pro Lp | Skilled Nursing Facility | 17521 Us Highway 69 S Ste 120, Tyler, TX 75703-5376 | 2014-01-23 |
| 1801228986 | Touchstone Strategies - Tyler LLC | Skilled Nursing Facility | 2650 Elkton Trl, Tyler, TX 75703-0580 | 2013-07-31 |
| 1790004679 | Touchstone Strategies, LLC | Skilled Nursing Facility | 2650 Elkton Trail, Tyler, TX 75703 | 2010-05-18 |
| 1255654133 | Sears Tyler Methodist Retirement Corporation | Skilled Nursing Facility | 16044 County Road 165, Tyler, TX 75703-7302 | 2010-03-08 |
| 1477694545 | Azalea Place Operating Company | Skilled Nursing Facility | 810 S Porter Ave, Tyler, TX 75701-2300 | 2007-02-09 |
| 1629135975 | Park Place Tyler Healthcare, LLC | Skilled Nursing Facility | 2450 E 5th St, Tyler, TX 75701-3525 | 2007-01-03 |
| 1477610814 | Melrose Hcc, LLC | Skilled Nursing Facility | 1501 W 29th St, Tyler, TX 75702-1404 | 2007-01-03 |
| 1770649659 | Hsmtx/reunion Plaza, LLC | Skilled Nursing Facility | 1401 Rice Rd, Tyler, TX 75703-3233 | 2006-12-28 |
| Find all providers in TYLER | ||||
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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.