Groesbeck LTC Partners, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

124523 Issued in TX

Legal business name

GROESBECK LTC PARTNERS, INC.

Practice address

607 Parkside Dr
Groesbeck, TX 76642-1124

Phone

(254) 729-3245

Fax

(254) 729-3788

NPI assigned

Jul 7, 2006

Last updated

Jan 12, 2015By 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

Mr. Louis Frederick Nicholson III, LNFA

Title

Ceo

Phone

(832) 489-9944

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421020800000",
    "number": "1497788269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 PARKSIDE DR",
            "city": "GROESBECK",
            "state": "TX",
            "postal_code": "766421124",
            "telephone_number": "254-729-3245",
            "fax_number": "254-729-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 PARKSIDE DR",
            "city": "GROESBECK",
            "state": "TX",
            "postal_code": "766421124",
            "telephone_number": "254-729-3245",
            "fax_number": "254-729-3788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROESBECK LTC PARTNERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2015-01-12",
        "status": "A",
        "authorized_official_last_name": "NICHOLSON",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "832-489-9944",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "LNFA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "124523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4909",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001013528",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Groesbeck, TX
• Providers in Groesbeck, 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 Jan 12, 2015; 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.