Organization Active NPI

Southwest LTC Kerrville LTD.

  • Skilled Nursing Facility
  • Kerrville, TX
National Provider Identifier
1366478521
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
118277 Issued in TX
Legal business name
SOUTHWEST LTC KERRVILLE LTD.
Practice address
2090 Bandera Hwy
Kerrville, TX 78028-6634
Phone
(830) 257-9900
Fax
(830) 257-9901
NPI assigned
Jun 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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

Authorized official

Name
Mr. Troy Clanton
Title
President
Phone
(817) 468-1991

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 118277 TX Primary

Addresses

Primary practice location

2090 Bandera Hwy
Kerrville, TX 78028-6634

Mailing address

2090 Bandera Hwy
Kerrville, TX 78028-6634
Phone (830) 257-9900

Other identifiers 1

IdentifierTypeStateIssuer
001014330MedicaidTX

Other names 1

  • River Hills Health & Rehabilitation Center Doing business as

National Provider Directory

National Provider Directory

Locations

2091 Bandera Hwy
Kerrville, TX 78028
Phone (830) 257-9900

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208908800000",
    "number": "1366478521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 BANDERA HWY",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780286634",
            "telephone_number": "830-257-9900",
            "fax_number": "830-257-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 BANDERA HWY",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780286634",
            "telephone_number": "830-257-9900",
            "fax_number": "830-257-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST LTC KERRVILLE LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2008-04-23",
        "status": "A",
        "authorized_official_last_name": "CLANTON",
        "authorized_official_first_name": "TROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-468-1991",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "118277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001014330",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River Hills Health & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kerrville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; 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.