Legend Oaks - West San Antonio

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

LEGEND OAKS - WEST SAN ANTONIO

Practice address

222 Bertetti
San Antonio, TX 78227

Phone

(240) 564-0100

Fax

(210) 564-0157

NPI assigned

Jul 14, 2011

Organization subpart

No

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

Authorized official

Name

Martin Tomerlin

Title

President/Coo

Phone

(210) 564-0100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Legend Oaks Healthcare and Rehabilitation - West San Antonio Doing business as

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427241600000",
    "number": "1609164441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 E BITTERS RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782162914",
            "telephone_number": "240-564-0100",
            "fax_number": "210-564-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 BERTETTI",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78227",
            "telephone_number": "240-564-0100",
            "fax_number": "210-564-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGEND OAKS - WEST SAN ANTONIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-14",
        "last_updated": "2015-03-25",
        "status": "A",
        "authorized_official_last_name": "TOMERLIN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT/COO",
        "authorized_official_telephone_number": "210-564-0100"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001019889",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legend Oaks Healthcare and Rehabilitation - West San Antonio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in San Antonio, TX
• Providers in San Antonio, 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 Mar 25, 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.