NPIMap

Organization Active NPI

Atria Grapevine

  • Assisted Living Facility
  • Grapevine, TX
National Provider Identifier
1073837589
Registry record updated Mar 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
030384 Issued in TX
Legal business name
ATRIA GRAPEVINE
Practice address
3975 William D Tate Ave
Grapevine, TX 76051-7109
Phone
(817) 416-8907
Fax
(817) 421-9792
NPI assigned
Mar 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2010

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

Authorized official

Name
Mr. Billy Ray Redmon Jr.
Title
Executive Director
Phone
(817) 416-8907

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 030384 TX Primary

Addresses

Primary practice location

3975 William D Tate Ave
Grapevine, TX 76051-7109

Mailing address

3975 William D Tate Ave
Grapevine, TX 76051-7109
Phone (817) 416-8907

Other names 1

  • Assisted Living Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2207381Atria Senior Living - Grapevine3975 William D Tate Ave, Grapevine, TX 76051Certificate of waiverDec 27, 2026

National Provider Directory

National Provider Directory
Tax ID family
A2002 Senior LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3975 William D Tate Ave
Grapevine, TX 76051
Phone (817) 416-8907

NPI Registry JSON

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

{
    "created_epoch": "1269561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269561600000",
    "number": "1073837589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3975 WILLIAM D TATE AVE",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760517109",
            "telephone_number": "817-416-8907",
            "fax_number": "817-421-9792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 WILLIAM D TATE AVE",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760517109",
            "telephone_number": "817-416-8907",
            "fax_number": "817-421-9792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATRIA GRAPEVINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-26",
        "last_updated": "2010-03-26",
        "status": "A",
        "authorized_official_last_name": "REDMON",
        "authorized_official_first_name": "BILLY",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "817-416-8907",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "030384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grapevine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.