South Oaks SCC LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SOUTH OAKS SCC LLC

Practice address

2101 Frate Barker Rd
Austin, TX 78748-3614

Phone

(512) 444-5627

Fax

(512) 368-2034

NPI assigned

Dec 16, 2014

Organization subpart

No

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

Authorized official

Name

Michael Beal

Title

Chief Executive Officer

Phone

(214) 252-7600

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Brodie Ranch Nursing & Rehab Center Doing business as

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

{
    "created_epoch": "1418688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1366840894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N PEARL ST STE 1050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752017495",
            "telephone_number": "214-252-7600",
            "fax_number": "214-252-7704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 FRATE BARKER RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787483614",
            "telephone_number": "512-444-5627",
            "fax_number": "512-368-2034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH OAKS SCC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-16",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "BEAL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "214-252-7600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001026612",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VENDOR ID/FACILITY ID",
            "identifier": "5586 104451",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brodie Ranch Nursing & Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brodie Ranch Nursing & Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• South Meadows Recovery, Inc.
• South Oaks Family Medicine, P.a.
• South Orange County Lithotripters, LLC
• South Texas Institutes of Health Inc
• Catherine A South, RN, FNP-BC
• Lynn Southard, MS, RD, CSP, LD
• Ainge Alexander Southerland, ACUPUNCTURIST

• Skilled Nursing Facility in Austin, TX
• Providers in Austin, 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 Mar 4, 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.