Park Place Tyler Healthcare, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PARK PLACE TYLER HEALTHCARE, LLC

Practice address

2450 E 5TH St
Tyler, TX 75701-3525

Phone

(903) 592-6745

Fax

(903) 592-1088

NPI assigned

Jan 3, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Sharon Kay Redd

Title

Reimbursement Specialists

Phone

(903) 881-9432

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• PARK PLACE NURSING & REHAB Doing business as

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328572800000",
    "number": "1629135975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 E 5TH ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013525",
            "telephone_number": "903-592-6745",
            "fax_number": "903-592-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 E 5TH ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013525",
            "telephone_number": "903-592-6745",
            "fax_number": "903-592-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PLACE TYLER HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2012-02-07",
        "status": "A",
        "authorized_official_last_name": "REDD",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "REIMBURSEMENT SPECIALISTS",
        "authorized_official_telephone_number": "903-881-9432",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001012142",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5390",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PARK PLACE NURSING & REHAB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Parent Services Center, Inc.
• Parent Services Center, Inc.
• Sahil Parikh, DO
• David Stephen Parish, M.D.
• Park Place Tyler HC, LLC
• Alex Park, PHARM.D
• Dana Michael Park, M.D.
• Daniel Jun Park, M.D.
• Jung Won Park, DDS
• Parker Health and Chiropractic PA

• Skilled Nursing Facility in Tyler, TX
• Providers in Tyler, 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 Feb 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.