PM Management-San Angelo NC II LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

123446 Issued in TX

Legal business name

PM MANAGEMENT-SAN ANGELO NC II LLC

Practice address

3745 Summer Crest Dr
San Angelo, TX 76901-9782

Phone

(325) 947-8776

Fax

(325) 224-2666

NPI assigned

Dec 11, 2006

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

Ceo

Phone

(512) 634-4900

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Trisun Care Center Regency House Doing business as

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251417600000",
    "number": "1104986041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 W. FIFTH ST",
            "address_2": "SUITE 700",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78703",
            "telephone_number": "512-634-4900",
            "fax_number": "512-634-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3745 SUMMER CREST DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769019782",
            "telephone_number": "325-947-8776",
            "fax_number": "325-224-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PM MANAGEMENT-SAN ANGELO NC II LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2009-08-28",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "LEW",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-634-4900",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "123446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY ID NO.",
            "identifier": "005370",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001013247",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trisun Care Center Regency House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Timothy Shaun Pittman, D.C.
• Jessica Marie Pizzola
• Stephan Gene Pizzola, MD
• Planned Parenthood of West Texas
• PM Management-San Angelo NC I LLC
• Srikanth Podaralla, M.D., M.B.A
• Lonnie M Pollard, DDS11/
• Amanda Leigh Pollitt, DO
• Billy Cleave Pool, LPC
• Deborah Ann Pope, CNS

• All providers in San Angelo, TX
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2009; 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.