Cedar Creek Nursing and Rehabilitation Center, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CEDAR CREEK NURSING AND REHABILITATION CENTER, INC

Practice address

159 Montague Drive
Bandera, TX 78003

Phone

(830) 460-3767

Fax

(830) 796-4791

NPI assigned

Feb 7, 2006

Last updated

Jun 13, 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

Umshaveni Govender

Title

Vice President

Phone

(972) 757-5115

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1487626099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 185159",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761810159",
            "telephone_number": "972-757-5115",
            "fax_number": "817-284-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 MONTAGUE DRIVE",
            "city": "BANDERA",
            "state": "TX",
            "postal_code": "78003",
            "telephone_number": "830-460-3767",
            "fax_number": "830-796-4791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR CREEK NURSING AND REHABILITATION CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-07",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "GOVENDER",
        "authorized_official_first_name": "UMSHAVENI",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "972-757-5115"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001012682",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Boyles Bandera Pharmacy (Boyles Bandera)
• Andy Breitbarth
• Jamye Sue Buckley
• Priya Butcher, LPC, LCDC
• Joyce Lynn Canion, PT
• Richard Clower, LCDC-I
• Comprehensive Physical Therapy
• Kenneth L Confer, LCDC
• Christy Coombes, SLP
• Veronica Corrales, PTA

• Skilled Nursing Facility in Bandera, TX
• Providers in Bandera, 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 Jun 13, 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.