Southwest LTC Athens LTD

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

113644 Issued in TX

Legal business name

SOUTHWEST LTC ATHENS LTD

Doing business as

Green Oaks Nursing Center

Practice address

500 Valle Vista Dr
Athens, TX 75751-2760

Phone

(903) 677-3434

Fax

(903) 677-5547

NPI assigned

Sep 7, 2005

Last updated

Aug 22, 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

Ronald R Payne, ESQ.

Title

Ceo

Phone

(469) 916-6100

Specialties & licenses 1

Addresses

Other names 1

• Green Oaks Nursing Center Doing business as

Locations

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225022122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17760 PRESTON RD",
            "address_2": "SUITE 310",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752525663",
            "telephone_number": "469-916-6100",
            "fax_number": "469-916-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 VALLE VISTA DR",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757512760",
            "telephone_number": "903-677-3434",
            "fax_number": "903-677-5547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST LTC ATHENS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "469-916-6100",
        "authorized_official_credential": "ESQ."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "113644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Green Oaks Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Athens, TX
• Providers in Athens, 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 Aug 22, 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.