Nacogdoches County Hospital District

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

NACOGDOCHES COUNTY HOSPITAL DISTRICT

Doing business as

Ponderosa Nursing & Rehabilitation Center

Practice address

12520 FM 1840
De Kalb, TX 75559-1929

Phone

(903) 667-2572

Fax

(903) 667-5589

NPI assigned

Jan 21, 2013

Organization subpart

No

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

Authorized official

Name

Gary Kendrick

Title

Ceo

Phone

(936) 568-8523

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ponderosa Nursing & Rehabilitation Center Doing business as

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

{
    "created_epoch": "1358726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511136000000",
    "number": "1487992889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 N MOUND ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614027",
            "telephone_number": "936-568-8523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12520 FM 1840",
            "city": "DE KALB",
            "state": "TX",
            "postal_code": "755591929",
            "telephone_number": "903-667-2572",
            "fax_number": "903-667-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NACOGDOCHES COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-21",
        "last_updated": "2017-11-20",
        "status": "A",
        "authorized_official_last_name": "KENDRICK",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "936-568-8523"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001021048",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ponderosa Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Blair Hodges, D.D.S.
• Hubbard Independent School District
• Ingram Health Consulting
• Lee Alison McCrary, APRN, NP-C
• Janet Marlene Moreland, PA
• Patient Access Foundation
• Myron Patrick
• Ponderosa Nursing and Rehabiliation
• Tracy Ratliff, NP
• Amy Nicole Rowan

• Skilled Nursing Facility in De Kalb, TX
• Providers in De Kalb, 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 Nov 20, 2017; 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.