Rock Creek Health and Rehabilitation LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

ROCK CREEK HEALTH AND REHABILITATION LLC

Practice address

1414 College St
Sulphur Springs, TX 75482-3431

Phone

(903) 439-0107

Fax

(903) 439-0147

NPI assigned

Nov 7, 2011

Last updated

Jul 27, 2012By 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. Michael G. Wallace

Title

President

Phone

(940) 387-4388

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1320624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343347200000",
    "number": "1689951543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N ELM ST",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762014137",
            "telephone_number": "940-387-4388",
            "fax_number": "940-380-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 COLLEGE ST",
            "city": "SULPHUR SPRINGS",
            "state": "TX",
            "postal_code": "754823431",
            "telephone_number": "903-439-0107",
            "fax_number": "903-439-0147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCK CREEK HEALTH AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-07",
        "last_updated": "2012-07-27",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "940-387-4388",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID CO B CROSS-OVER",
            "identifier": "295239201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001020121",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert P Shackelford (Sulphur Springs Orthopedic)
• Robert P Shackelford M D (Sulphur Springs Orthopedics)
• Robert P Shackelford MD (Sulphur Springs Orthopedic)
• Joel Robinson, DPM
• Tyler Evan Robison, DMD
• Abbey Ellen Roper, NP-C
• Daniel P Roper Jr., D.D.S.
• Donald Roseberry, PA-C
• Kaitlyn Brooke Sachs, LMSW
• Saltillo Isd

• Skilled Nursing Facility in Sulphur Springs, TX
• Providers in Sulphur Springs, 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 Jul 27, 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.