SCC Partners, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SCC PARTNERS, INC.

Doing business as

Broadmoor Medical Lodge

Practice address

5242 Medical Dr
Rockwall, TX 75032-5001

Phone

(972) 772-8700

Fax

(972) 772-8701

NPI assigned

Nov 19, 2012

Organization subpart

Yes

Parent organization

SCC HEALTHCARE GROUP, LTD.As reported in NPPES

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

Authorized official

Name

Renee Crabb

Title

Executive Assistant

Phone

(972) 303-7500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Broadmoor Medical Lodge Doing business as

Locations

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416528000000",
    "number": "1083958862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 E I 30",
            "address_2": "SUITE 7",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750434784",
            "telephone_number": "972-303-9000",
            "fax_number": "972-303-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5242 MEDICAL DR",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750325001",
            "telephone_number": "972-772-8700",
            "fax_number": "972-772-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCC PARTNERS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SCC HEALTHCARE GROUP, LTD.",
        "enumeration_date": "2012-11-19",
        "last_updated": "2014-11-21",
        "status": "A",
        "authorized_official_last_name": "CRABB",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
        "authorized_official_telephone_number": "972-303-7500"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001021016",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broadmoor Medical Lodge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Martha Saucier, AGNP-C
• Savannah Martinez (ABA Therapy)
• Tiffany Michelle Saylor
• Lashica Y Scaife, APRN
• Scania Home Health Care Inc
• Taylor Schackart, FNP-C
• Detra A Scheele
• Hailey Schmaltz
• Brent David Schmidlap, O.D.
• Tyler Colton Schmitz

• Skilled Nursing Facility in Rockwall, TX
• Providers in Rockwall, 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 Nov 21, 2014; 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.