Shady Shores of Corpus Christi LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SHADY SHORES OF CORPUS CHRISTI LLC

Doing business as

Vista Del Mar Health & Rehabilitation

Practice address

1314 3Rd St
Corpus Christi, TX 78404-2208

Phone

(361) 888-5511

Fax

(361) 888-6267

NPI assigned

Jan 29, 2016

Last updated

Jan 29, 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

Michael Wallace

Title

Ceo

Phone

(214) 422-1622

Specialties & licenses 1

Addresses

Other names 1

• Vista Del Mar Health & Rehabilitation Doing business as

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

{
    "created_epoch": "1454025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454025600000",
    "number": "1588022057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 EAGLE DR",
            "address_2": "SUITE 201",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762016898",
            "telephone_number": "214-422-1622",
            "fax_number": "972-755-6795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 3RD ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784042208",
            "telephone_number": "361-888-5511",
            "fax_number": "361-888-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADY SHORES OF CORPUS CHRISTI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-29",
        "last_updated": "2016-01-29",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-422-1622"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vista Del Mar Health & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carrie Marie Sessions, FNP-C
• Ashley Setterberg, OD
• Seventh Day Healthcare Staffing, LLC.
• Gwyneth E Seward, LPTA
• Roxanna Shababi
• William Lee Shaffer, M.D.
• Shiva Shafiei
• Birva Shah
• Prachi Shah, DO
• Jared Ty Shahan, M.D.

• Skilled Nursing Facility in Corpus Christi, TX
• Providers in Corpus Christi, 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 29, 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.