Organization Active NPI

Robertson County Nursing Home, Inc.

Doing business as Calvert Nursing Home

  • Nursing Facility/Intermediate Care Facility
  • Calvert, TX
National Provider Identifier
1558368993
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
108535 Issued in TX
Legal business name
ROBERTSON COUNTY NURSING HOME, INC.
Doing business as
Calvert Nursing Home
Practice address
701 E Browning St
Calvert, TX 77837-7593
Phone
(979) 364-2391
Fax
(979) 364-2798
NPI assigned
Jun 30, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Cheryl L Killian
Title
President
Phone
(817) 654-3042

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 108535 TX Primary

Addresses

Primary practice location

701 E Browning St
Calvert, TX 77837-7593

Mailing address

3801 Woodside Dr
Arlington, TX 76016-3030
Phone (817) 654-3042

Other identifiers 1

IdentifierTypeStateIssuer
4365MedicaidTX

Other names 1

  • Calvert Nursing Home Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558368993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 WOODSIDE DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760163030",
            "telephone_number": "817-654-3042",
            "fax_number": "817-446-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E BROWNING ST",
            "city": "CALVERT",
            "state": "TX",
            "postal_code": "778377593",
            "telephone_number": "979-364-2391",
            "fax_number": "979-364-2798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERTSON COUNTY NURSING HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KILLIAN",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-654-3042",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TX",
            "license": "108535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4365",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Calvert Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Calvert, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.