Resort Lodge, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

RESORT LODGE, INC.

Practice address

401 NW 4TH St
Mineral Wells, TX 76067-4814

Phone

(940) 325-3744

Fax

(940) 328-1463

NPI assigned

Nov 21, 2006

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

Mr. Joe Kearby

Title

Owner

Phone

(940) 325-3744

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Bryant Stroud, MD

  • Dermatology Physician
  • Granbury, TX
  • NPI 1215928767
  NPD (past)

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235204942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 NW 4TH ST",
            "city": "MINERAL WELLS",
            "state": "TX",
            "postal_code": "760674814",
            "telephone_number": "940-325-3744",
            "fax_number": "940-328-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 NW 4TH ST",
            "city": "MINERAL WELLS",
            "state": "TX",
            "postal_code": "760674814",
            "telephone_number": "940-325-3744",
            "fax_number": "940-328-1463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESORT LODGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KEARBY",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "940-325-3744",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janardhana P Reddy, M.D. , FACS
• Ashleigh Kay Reed
• Kayla Reed
• Mark Brennan Reimer, M.D.
• Reserve Diagnostic Lab
• Richard W Hoefelmann MD PA
• Robert C Allensworth MD,PA
• Janet L Rounsville, FNP-C
• Ryan Freemyer
• Ryan Freemyer MD PA

• Skilled Nursing Facility in Mineral Wells, TX
• Providers in Mineral Wells, 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.