Azalea Place Operating Company

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

4734 Issued in TX

Legal business name

AZALEA PLACE OPERATING COMPANY

Practice address

810 S Porter Ave
Tyler, TX 75701-2300

Phone

(903) 593-2463

Fax

(903) 597-1203

NPI assigned

Feb 9, 2007

Last updated

Aug 22, 2020By 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

Kimberly Ann Hunter

Title

Business Office Manager

Phone

(903) 593-2463

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477694545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 S PORTER AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012300",
            "telephone_number": "903-593-2463",
            "fax_number": "903-597-1203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 S PORTER AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012300",
            "telephone_number": "903-593-2463",
            "fax_number": "903-597-1203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZALEA PLACE OPERATING COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HUNTER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "903-593-2463"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "4734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VENDOR ID#",
            "identifier": "4734",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Macy Ayres, CPNP-PC
• Azalea
• Azalea Academy for Exceptional Adults
• Azalea Internal Medicine Associates PA
• Azalea Orthopedic & Sports Medicine Clinic PA
• Samareh Cunningham Azar, MD
• Jasmine Azghani Vardeman, NP-C
• Azleway Inc.
• Naga Azzarapu
• Eli Azzi, MD

• Skilled Nursing Facility in Tyler, TX
• Providers in Tyler, TX by specialty
• Skilled Nursing Facility in Texas

• 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.