Spring Creek Nursing and Rehabilitation LP

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SPRING CREEK NURSING AND REHABILITATION LP

Practice address

2660 Brickyard Rd
Beaumont, TX 77703-4708

Phone

(409) 892-1533

Fax

(409) 892-1405

NPI assigned

Sep 27, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Dan D Flagg

Title

Ceo

Phone

(940) 387-4388

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549929600000",
    "number": "1164418935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 S ELM ST",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762016085",
            "telephone_number": "940-387-4388",
            "fax_number": "940-380-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 BRICKYARD RD",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777034708",
            "telephone_number": "409-892-1533",
            "fax_number": "409-892-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRING CREEK NURSING AND REHABILITATION LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2019-02-12",
        "status": "A",
        "authorized_official_last_name": "FLAGG",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "940-387-4388",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001004117",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TMHP  CROSS OVER",
            "identifier": "1553372 02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; 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.