Active NPI
BLC - Patriot Heights, LLC
- Skilled Nursing Facility
- San Antonio, TX
National Provider Identifier
1538119367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 114144
- Legal business name
- BLC - PATRIOT HEIGHTS, LLC
- Doing business as
- Brookdale Patriot Heights
- Practice address
- 5000 Fawn MDWS
San Antonio, TX 78240-1539 - Phone
- (210) 696-6005
- Fax
- (210) 641-7881
- NPI assigned
- May 11, 2006
- Organization subpart
- Yes
- Parent organization
- BROOKDALE SENIOR LIVING INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Mark W Ohlendorf
- Title
- President
- Phone
- (312) 977-3700
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 114148 | TX | |
| Skilled Nursing Facility | 314000000X | 114144 | TX | Primary |
Addresses
Primary practice location
5000 Fawn MDWS
San Antonio, TX 78240-1539
Mailing address
111 Westwood PL
Suite 400
Brentwood, TN 37027-5021
Phone (615) 221-2250
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001013188 | Medicaid | TX |
Other names 1
- Brookdale Patriot Heights
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Outpatient physical therapy / speech pathology certification: CCN 676689
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- BROOKDALE THERAPY PATRIOT HEIGHTS
- Certification status
- Active
- Provider type (POS)
- Outpatient physical therapy / speech pathology
- Participating since
- Nov 2, 2011
- Last certification
- Nov 2, 2011
- Ownership / control type
- Proprietary
- Facility address
- 5000 Fawn Meadow
San Antonio, TX 78240
National Provider Directory
National Provider Directory- Part of
- Brookdale Senior Living Inc
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1423612800000",
"number": "1538119367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 WESTWOOD PL",
"address_2": "SUITE 400",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370275021",
"telephone_number": "615-221-2250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000 FAWN MDWS",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782401539",
"telephone_number": "210-696-6005",
"fax_number": "210-641-7881"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BLC - PATRIOT HEIGHTS, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BROOKDALE SENIOR LIVING INC",
"enumeration_date": "2006-05-11",
"last_updated": "2015-02-11",
"status": "A",
"authorized_official_last_name": "OHLENDORF",
"authorized_official_first_name": "MARK",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "312-977-3700",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "TX",
"license": "114148",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "TX",
"license": "114144",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001013188",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Brookdale Patriot Heights",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.