Willow Bluff LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

114059 Issued in TX

Legal business name

WILLOW BLUFF LLC

Doing business as

The Willows of Kilgore

Practice address

1901 Whipporwill LN
Kilgore, TX 75662-3880

Phone

(903) 983-7775

NPI assigned

Dec 8, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Sondra Scalco, LNFA

Title

Administrator

Phone

(903) 983-7775

Specialties & licenses 1

Addresses

Other names 1

• The Willows of Kilgore Doing business as

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336124643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 WHIPPORWILL LN",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756623880",
            "telephone_number": "903-983-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 WHIPPORWILL LN",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756623880",
            "telephone_number": "903-983-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW BLUFF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCALCO",
        "authorized_official_first_name": "SONDRA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "903-983-7775",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LNFA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "114059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Willows of Kilgore",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Samuel Watson Weaver, PTA
• Christina Whisenhunt
• Marcy Lee Whitmer, DDS
• Deborah C Williams, LPC
• Kimberley Elisabeth Williams, PTA
• Woc903 Transport LLC
• John K. Wolcott, MD
• Sonja Denice Woodburn, RN
• Austin Charles Word, PA
• Marcy ( Tanya ) Marcelle Word

• Skilled Nursing Facility in Kilgore, TX
• Providers in Kilgore, 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.