Fort Worth Nursing & Rehabilitation Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

109618 Issued in TX

Legal business name

FORT WORTH NURSING & REHABILITATION CENTER

Practice address

1000 6TH Ave
Fort Worth, TX 76104-2808

Phone

(817) 336-2586

Fax

(817) 336-6620

NPI assigned

Oct 10, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Dick Stebbins, CPA

Title

President of General Partner

Phone

(903) 757-5360

Specialties & licenses 3

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1053309575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E WHALEY ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756016525",
            "telephone_number": "903-757-5360",
            "fax_number": "903-753-8621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 6TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042808",
            "telephone_number": "817-336-2586",
            "fax_number": "817-336-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WORTH NURSING & REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "STEBBINS",
        "authorized_official_first_name": "DICK",
        "authorized_official_title_or_position": "PRESIDENT OF GENERAL PARTNER",
        "authorized_official_telephone_number": "903-757-5360",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "109618",
            "primary": true
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "TX",
            "license": "109618",
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "TX",
            "license": "109618",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000400403",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HO4554608",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "094414202",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "094414201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fort Worth Medical Associates, PLLC
• Fort Worth Medical Specialists PLLC
• Fort Worth Medtex LP
• Fort Worth Midwives LLC
• Fort Worth Northside Community Health Center
• Fort Worth Occmed, LLC
• Fort Worth Orthopedic Surgery & Sports Medicine, P.a.
• Fort Worth Osteopathc Hospital, Inc.
• Fort Worth Pain Management Center LLC
• Fort Worth Pediatric Dentistry

• Skilled Nursing Facility in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.