PM Management - Corsicana NC LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

132867 Issued in TX

Legal business name

PM MANAGEMENT - CORSICANA NC LLC

Doing business as

Trisun Care Center - Corsicana

Practice address

3210 W State Highway 22
Corsicana, TX 75110-2449

Phone

(903) 872-4880

Fax

(903) 641-0391

NPI assigned

Jan 6, 2010

Last updated

Mar 4, 2020By 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

Michael Beal

Title

Chief Executive Officer

Phone

(214) 252-7600

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Trisun Care Center - Corsicana Doing business as

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

{
    "created_epoch": "1262736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1174853600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N PEARL ST STE 1050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752017495",
            "telephone_number": "214-252-7600",
            "fax_number": "214-252-7704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3210 W STATE HIGHWAY 22",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751102449",
            "telephone_number": "903-872-4880",
            "fax_number": "903-641-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PM MANAGEMENT - CORSICANA NC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-06",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "BEAL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "214-252-7600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "132867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAC. ID",
            "identifier": "104875",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001019862",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trisun Care Center - Corsicana",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Trisun Care Center - Corsicana",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffrey Scott Petty, DPM
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• Justin B Pillans, DDS
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• PM Management -Corsicana NC II, LLC (Heritage Oaks Retirement Village (ALF))
• PM Management Corsicana NC II LLC (Heritage Oaks Retirement Village)
• Podiatric Medical Partners of Texas, PA (Family Foot & Ankle Centers)
• Tara Podjenski, LPC
• Maria Del Pilar Ponce, APRN

• Skilled Nursing Facility in Corsicana, TX
• Providers in Corsicana, 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 Mar 4, 2020; 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.