Memphis I Enterprises, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MEMPHIS I ENTERPRISES, LLC

Doing business as

Memphis Convalescent Center

Practice address

1415 N 18TH St
Memphis, TX 79245-2009

Phone

(806) 259-3566

Fax

(806) 259-5098

NPI assigned

Dec 18, 2008

Last updated

Aug 30, 2021By 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

Gary Blake

Title

Managing Member

Phone

(817) 348-8959

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Memphis Convalescent Center Doing business as

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

{
    "created_epoch": "1229558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630281600000",
    "number": "1336385442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 N 18TH ST",
            "city": "MEMPHIS",
            "state": "TX",
            "postal_code": "792452009",
            "telephone_number": "806-259-3566",
            "fax_number": "806-259-5098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 N 18TH ST",
            "city": "MEMPHIS",
            "state": "TX",
            "postal_code": "792452009",
            "telephone_number": "806-259-3566",
            "fax_number": "806-259-5098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMPHIS I ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-18",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "817-348-8959"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001016680",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VENDOR",
            "identifier": "005131",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memphis Convalescent Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memphis Convalescent Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Childress County Hospital District (Memphis Convalescent Center)
• Clinic for Family Wellness PLLC
• Jana Kay Gonzalez, RPH
• Hall County EMS, Inc.
• Mark E. Hundley, PLLC
• Memphis Independent School District (Memphis ISD)
• Carole D Ward, FNPC
• Zues Leasing LLC (Memphis Convalescent Center)

• Skilled Nursing Facility in Memphis, TX
• Providers in Memphis, 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 30, 2021; 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.