Autumn Wind

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

105574 Issued in TX

Legal business name

AUTUMN WIND

Practice address

135 Autumn Wind CT
Mineola, TX 75773-0017

Phone

(903) 569-1111

Fax

(903) 569-6007

NPI assigned

Sep 9, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Melissa G Dyer, L.V.N.

Title

Administrator

Phone

(903) 434-9300

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1378684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378684800000",
    "number": "1477988558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 AUTUMN WIND CT",
            "city": "MINEOLA",
            "state": "TX",
            "postal_code": "757730017",
            "telephone_number": "903-569-1111",
            "fax_number": "903-569-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 AUTUMN WIND CT",
            "city": "MINEOLA",
            "state": "TX",
            "postal_code": "757730017",
            "telephone_number": "903-569-1111",
            "fax_number": "903-569-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTUMN WIND",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-09",
        "last_updated": "2013-09-09",
        "status": "A",
        "authorized_official_last_name": "DYER",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "903-434-9300",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "L.V.N."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "105574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A Nutrient in Time
• Jacob Miller Allen, DDS
• Jodi Leeann Bane, LPC
• Diana Bankhead, MD
• Amber Barnes
• Nicole Rhea Bennett, PMHNP
• Bluebonnet Hospice of East Texas Inc

• All providers in Mineola, TX
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; 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.