PM Management - Killeen IV NC LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

131729 Issued in TX

Legal business name

PM MANAGEMENT - KILLEEN IV NC LLC

Doing business as

Wind Crest Rehab and Nursing Center

Practice address

607 W Ave B
Copperas Cove, TX 76522-1553

Phone

(254) 547-1033

Fax

(254) 542-3506

NPI assigned

Jan 25, 2011

Last updated

Aug 11, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lew N Little Jr.

Title

Manager

Phone

(512) 634-4900

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Wind Crest Rehab and Nursing Center Doing business as

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

{
    "created_epoch": "1295913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313020800000",
    "number": "1083919856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 W 5TH ST",
            "address_2": "SUITE 700",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787034893",
            "telephone_number": "512-634-4900",
            "fax_number": "512-634-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 W AVE B",
            "city": "COPPERAS COVE",
            "state": "TX",
            "postal_code": "765221553",
            "telephone_number": "254-547-1033",
            "fax_number": "254-542-3506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PM MANAGEMENT - KILLEEN IV NC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-25",
        "last_updated": "2011-08-11",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "LEW",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "512-634-4900",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "131729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001019294",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY ID",
            "identifier": "005154",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wind Crest Rehab and Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pelebo Home Visits LLC
• Tara Penny, PHARMD
• Christopher Perez, M.S
• Heidi Perez, RPH
• Lori Pettigrew, MSN, APRN, FNP-C
• Laura Pontius
• Barbara Jean Prescott, NP
• Primecare Equipment Supply LLC
• Jessica Jean Raines, LVN
• Melissa Ramirez

• Skilled Nursing Facility in Copperas Cove, TX
• Providers in Copperas Cove, 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 11, 2011; 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.