Mason Mesquite Op, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MASON MESQUITE OP, LLC

Doing business as

Edgewood Rehabilitation and Care Center

Practice address

1101 Windbell Drive
Mesquite, TX 75149

Phone

(469) 341-2720

NPI assigned

Jun 7, 2012

Organization subpart

No

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

Authorized official

Name

M. Craig Kelly

Title

Sole Member

Phone

(469) 341-2720

Specialties & licenses 1

Addresses

Other names 1

• Edgewood Rehabilitation and Care Center Doing business as

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339027200000",
    "number": "1619238425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4949 WESTGROVE DR",
            "address_2": "SUITE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481923",
            "telephone_number": "469-341-2720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 WINDBELL DRIVE",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "75149",
            "telephone_number": "469-341-2720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASON MESQUITE OP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-07",
        "last_updated": "2012-06-07",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "M.",
        "authorized_official_middle_name": "CRAIG",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "469-341-2720"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edgewood Rehabilitation and Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Janice Jones Marshall, MD
• Martin Jackson DPM PSC
• Camille Martinez
• Stephanie Martinez, LVN
• Kasirim Masi
• Samuel L. Mason, D.D.S.
• Masons Personal Care Homes Inc
• Farbod Masrour, D.O,
• Warner Barron Massey, MD
• Melody Lane Matej, FNP-C

• Skilled Nursing Facility in Mesquite, TX
• Providers in Mesquite, 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 7, 2012; 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.