Wind Crest Nursing Center Inc

Primary specialty

Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X

License

116809 Issued in TX

Legal business name

WIND CREST NURSING CENTER INC

Practice address

607 W Avenue B
Copperas Cove, TX 76522-1553

Phone

(254) 547-1033

Fax

(254) 542-3506

NPI assigned

Jul 4, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kimberly M Scullark

Title

Medicare Coordinator

Phone

(863) 646-5951

Specialties & licenses 1

Addresses

Other identifiers 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277078400000",
    "number": "1043240096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 W AVENUE B",
            "city": "COPPERAS COVE",
            "state": "TX",
            "postal_code": "765221553",
            "telephone_number": "254-547-1033",
            "fax_number": "254-542-3506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 W AVENUE B",
            "city": "COPPERAS COVE",
            "state": "TX",
            "postal_code": "765221553",
            "telephone_number": "254-547-1033",
            "fax_number": "254-542-3506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIND CREST NURSING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2010-06-21",
        "status": "A",
        "authorized_official_last_name": "SCULLARK",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICARE COORDINATOR",
        "authorized_official_telephone_number": "863-646-5951"
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "TX",
            "license": "116809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000515401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021431401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Edmond Wicheta IV, DDS
• Megan Rae Widder, MS, CCC-SLP
• Corey Willems, PA-C
• Eunice Williams, RN
• Kathy Jo Williams
• Winnie-Stowell Hospital District
• Tiffany Woodward, LVN
• Petra Wyche, FNP
• Lauren Yam, PHARMD
• Sarah Elaine Yawn, DPT

• Pediatric Skilled Nursing Facility in Copperas Cove, TX
• Providers in Copperas Cove, TX by specialty
• Pediatric Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.