Plano Healthcare Residence Operator LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

134185 Issued in TX

Legal business name

PLANO HEALTHCARE RESIDENCE OPERATOR LLC

Doing business as

Heritage Manor Healthcare Residence

Practice address

1621 Coit Rd
Plano, TX 75075-6141

Phone

(972) 596-7930

Fax

(972) 867-6788

NPI assigned

Feb 25, 2015

Last updated

Jun 21, 2016By 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

Joe Neuman

Title

Ceo

Phone

(214) 396-3462

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Heritage Manor Healthcare Residence Doing business as

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Katy Bagwill, CRNA

  • Certified Registered Nurse Anesthetist
  • Arlington, TX
  • NPI 1700207495
  NPD (past)
• Tyler John Lee Benson, D.O.

  • Family Medicine Physician
  • Nocona, TX
  • NPI 1467985671
  NPD (past)
• Chance Wayne Dingler, MD

  • Family Medicine Physician
  • Nocona, TX
  • NPI 1780743898
  NPD (past)
• Jason M Harrison, MD

  • Surgery Physician
  • Arlington, TX
  • NPI 1679547863
  NPD (past)
• Kelly Roden, MD

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1730538513
  NPD (past)

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

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466467200000",
    "number": "1518359728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 COIT RD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750756141",
            "telephone_number": "972-596-7930",
            "fax_number": "972-867-6788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 COIT RD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750756141",
            "telephone_number": "972-596-7930",
            "fax_number": "972-867-6788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLANO HEALTHCARE RESIDENCE OPERATOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-25",
        "last_updated": "2016-06-21",
        "status": "A",
        "authorized_official_last_name": "NEUMAN",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-396-3462"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "134185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001026813",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Manor Healthcare Residence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Plano Eye Care Surgery Center PLLC
• Plano Family Clinic PLLC
• Plano Family Dental
• Plano Family Practice and Sports Medicine, P.a.
• Plano Group Health, LLC
• Plano Hearing Care PLLC
• Plano Heart Center, P.a.
• Plano Independent School District (Davis Elementary School)
• Plano Independent School District
• Plano Injury Rehab

• Skilled Nursing Facility in Plano, TX
• Providers in Plano, 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 21, 2016; 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.