NPIMap

Organization Active NPI

East Texas LTC the Waterton at Shiloh LLC

  • Skilled Nursing Facility
  • Tyler, TX
National Provider Identifier
1447525803
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
EAST TEXAS LTC THE WATERTON AT SHILOH LLC
Practice address
2875 Shiloh Rd
Tyler, TX 75703-2936
Phone
(903) 561-1300
NPI assigned
Mar 19, 2012
Last updated
Jun 20, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Authorized official

Name
Carla Power
Title
Cfo
Phone
(903) 792-0838

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

2875 Shiloh Rd
Tyler, TX 75703-2936

Mailing address

2875 Shiloh Rd
Tyler, TX 75703-2936
Phone (903) 561-1300

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1447525803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2875 SHILOH RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757032936",
            "telephone_number": "903-561-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 SHILOH RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757032936",
            "telephone_number": "903-561-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS LTC THE WATERTON AT SHILOH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-19",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "POWER",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "903-792-0838"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.