Rio One at Tarrant County, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

RIO ONE AT TARRANT COUNTY, LLC

Practice address

3729 Ira E Woods Ave
Grapevine, TX 76051-4213

Phone

(817) 809-8000

NPI assigned

Nov 16, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Kelley Whitaker

Title

Chief Operations Officer

Phone

(505) 369-0079

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• The Lodge at Bear Creek Doing business as

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

{
    "created_epoch": "1447632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471824000000",
    "number": "1083088959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8820 HORIZON BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131689",
            "telephone_number": "505-369-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3729 IRA E WOODS AVE",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760514213",
            "telephone_number": "817-809-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIO ONE AT TARRANT COUNTY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-16",
        "last_updated": "2016-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITAKER",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "505-369-0079",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001027384",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "802160926",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Lodge at Bear Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Steven Richardson
• Brennan J Riche', DC
• Allison Haley Rigg
• Shawn Riley, M.D.
• Rim Endeavors, LLC
• Charles Mike Rios, MD
• Julio R Rivera, M.D.
• Ariana Rivero, LMFT-ASSOCIATE
• RKS & Associates LLC
• RLS Supermarkets LLC

• Skilled Nursing Facility in Grapevine, TX
• Providers in Grapevine, 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 Aug 22, 2016; 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.