Organization Active NPI

Ridgecrest Retirement Center, LTD

  • Skilled Nursing Facility
  • Waco, TX
National Provider Identifier
1407830144
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
109995 Issued in TX
Legal business name
RIDGECREST RETIREMENT CENTER, LTD
Practice address
1900 W Highway 6
Waco, TX 76712-9729
Phone
(254) 776-9681
Fax
(254) 776-7960
NPI assigned
Dec 6, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mike Hawker
Title
Chief Financial Officer
Phone
(210) 340-7155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 109995 TX Primary

Addresses

Primary practice location

1900 W Highway 6
Waco, TX 76712-9729

Mailing address

845 Proton Rd
San Antonio, TX 78258-4203
Phone (210) 582-3716

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407830144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 PROTON RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584203",
            "telephone_number": "210-582-3716",
            "fax_number": "210-582-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 W HIGHWAY 6",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767129729",
            "telephone_number": "254-776-9681",
            "fax_number": "254-776-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGECREST RETIREMENT CENTER, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAWKER",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "210-340-7155"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "109995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • 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.