NPIMap

Organization Active NPI

Grace Care of Texas, Inc.

Doing business as Community Care Center of Crockett

  • Skilled Nursing Facility
  • Crockett, TX
National Provider Identifier
1427042217
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
114799 Issued in TX
Legal business name
GRACE CARE OF TEXAS, INC.
Doing business as
Community Care Center of Crockett
Practice address
150 E Loop 304
Crockett, TX 75835
Phone
(936) 544-2051
Fax
(936) 544-8605
NPI assigned
Sep 7, 2005
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
Donald J McKay
Title
Cfo
Phone
(940) 442-6020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 114799 TX Primary

Addresses

Primary practice location

150 E Loop 304
Crockett, TX 75835

Mailing address

150 E Loop 304
Crockett, TX 75835
Phone (936) 544-2051

Other identifiers 1

IdentifierTypeStateIssuer
004802MedicaidTX

Other names 1

  • Community Care Center of Crockett Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Grace Care of Texas Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427042217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E LOOP 304",
            "city": "CROCKETT",
            "state": "TX",
            "postal_code": "75835",
            "telephone_number": "936-544-2051",
            "fax_number": "936-544-8605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E LOOP 304",
            "city": "CROCKETT",
            "state": "TX",
            "postal_code": "75835",
            "telephone_number": "936-544-2051",
            "fax_number": "936-544-8605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE CARE OF TEXAS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCKAY",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "940-442-6020"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "114799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Care Center of Crockett",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crockett, 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.