Amerisa,Inc.

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

111061 Issued in TX

Legal business name

AMERISA,INC.

Doing business as

Tumbleweed

Practice address

1101 E Lake St
Brownfield, TX 79316-3811

Phone

(806) 637-7561

Fax

(806) 637-6230

NPI assigned

Oct 31, 2005

Last updated

Oct 22, 2008By 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

Mr. Roy Puente

Title

Partner

Phone

(806) 438-0266

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tumbleweed Doing business as

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224633600000",
    "number": "1417948381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 E LAKE ST",
            "city": "BROWNFIELD",
            "state": "TX",
            "postal_code": "793163811",
            "telephone_number": "806-637-7561",
            "fax_number": "806-637-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 E LAKE ST",
            "city": "BROWNFIELD",
            "state": "TX",
            "postal_code": "793163811",
            "telephone_number": "806-637-7561",
            "fax_number": "806-637-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERISA,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2008-10-22",
        "status": "A",
        "authorized_official_last_name": "PUENTE",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "806-438-0266",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TX",
            "license": "111061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001015174",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tumbleweed",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.