Organization Active NPI

Park Place Tyler HC, LLC

Doing business as Park Place Nursing & Rehab

  • Nursing Facility/Intermediate Care Facility
  • Tyler, TX
National Provider Identifier
1184954828
Registry record updated Dec 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
Legal business name
PARK PLACE TYLER HC, LLC
Doing business as
Park Place Nursing & Rehab
Practice address
2450 E 5TH St
Tyler, TX 75701-3525
Phone
(903) 592-6745
Fax
(903) 592-1088
NPI assigned
Dec 31, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2009

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

Authorized official

Name
Ms. Sharon Kay Redd
Title
Reimbursement Specialists
Phone
(903) 881-9432

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X TX Primary

Addresses

Primary practice location

2450 E 5TH St
Tyler, TX 75701-3525

Mailing address

2450 E 5TH St
Tyler, TX 75701-3525
Phone (903) 592-6745

Other identifiers 2

IdentifierTypeStateIssuer
001012142MedicaidTX
5390MedicaidTX

Other names 1

  • PARK PLACE NURSING & REHAB Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1262217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262217600000",
    "number": "1184954828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 E 5TH ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013525",
            "telephone_number": "903-592-6745",
            "fax_number": "903-592-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 E 5TH ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013525",
            "telephone_number": "903-592-6745",
            "fax_number": "903-592-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PLACE TYLER HC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-31",
        "last_updated": "2009-12-31",
        "status": "A",
        "authorized_official_last_name": "REDD",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "REIMBURSEMENT SPECIALISTS",
        "authorized_official_telephone_number": "903-881-9432",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001012142",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5390",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PARK PLACE NURSING & REHAB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.