Rockport Coastal Care Center, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

110464 Issued in TX

Legal business name

ROCKPORT COASTAL CARE CENTER, INC.

Practice address

1004 S Young St
Rockport, TX 78382-3933

Phone

(361) 729-1228

Fax

(361) 729-1299

NPI assigned

Aug 11, 2006

Last updated

Jun 24, 2015By 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

Mr. Bradley S. McDonald, LNHA

Title

Administrator/Owner

Phone

(361) 729-1228

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435104000000",
    "number": "1619988904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 S YOUNG ST",
            "city": "ROCKPORT",
            "state": "TX",
            "postal_code": "783823933",
            "telephone_number": "361-729-1228",
            "fax_number": "361-729-1299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 S YOUNG ST",
            "city": "ROCKPORT",
            "state": "TX",
            "postal_code": "783823933",
            "telephone_number": "361-729-1228",
            "fax_number": "361-729-1299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKPORT COASTAL CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2015-06-24",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "361-729-1228",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "110464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5200",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001001322",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• RJK Medical PC
• Rockport Medical Clinic LLC (Coastal Medical Clinic)
• Rockport Physical Medicine PA
• Rockport Therapy Clinic, LLC
• Rockport Urgent Care Center
• Rockport Wellness Center, LLC

• Skilled Nursing Facility in Rockport, TX
• Providers in Rockport, 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 24, 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.