FMSC Collierville Operating Company LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

236 Issued in TN

Legal business name

FMSC COLLIERVILLE OPERATING COMPANY LLC

Doing business as

Collierville Health and Rehabilitation Center

Practice address

490 W Poplar Ave
Collierville, TN 38017-2538

Phone

(901) 853-8561

Fax

(901) 853-1341

NPI assigned

May 9, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Dennis Sarcauga

Title

Vice President of Operations

Phone

(305) 892-1790

Specialties & licenses 1

Addresses

Other names 1

• Collierville Health and Rehabilitation Center Doing business as

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386693265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 W POPLAR AVE",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380172538",
            "telephone_number": "901-853-8561",
            "fax_number": "901-853-1341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 W POPLAR AVE",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380172538",
            "telephone_number": "901-853-8561",
            "fax_number": "901-853-1341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMSC COLLIERVILLE OPERATING COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SARCAUGA",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "305-892-1790",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Collierville Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Flores
• Amber Floyd-Wehrenberg
• Brandalon Marie Fly, APRN, FNP-BC
• Tina Fly
• FMSC Collierville Operating Company
• Erin Michelle Fontana, PTA
• Ira Dean Fontenot, P.D.
• Amir Victor Francis, D.D.S
• Alan Fredericks, D.C.
• George Nathan Freeman III, DC

• Skilled Nursing Facility in Collierville, TN
• Providers in Collierville, TN by specialty
• Skilled Nursing Facility in Tennessee

• 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.