Legend Oaks - San Angelo, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

5472 Issued in TX

Legal business name

LEGEND OAKS - SAN ANGELO, LLC

Practice address

5455 Knickerbocker Rd
San Angelo, TX 76904-7711

Phone

(325) 944-1600

Fax

(325) 944-1660

NPI assigned

Jul 13, 2006

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

Phone

(210) 564-0100

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192147200000",
    "number": "1720003536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 KNICKERBOCKER RD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047711",
            "telephone_number": "325-944-1600",
            "fax_number": "325-944-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 KNICKERBOCKER RD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047711",
            "telephone_number": "325-944-1600",
            "fax_number": "325-944-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGEND OAKS - SAN ANGELO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-10-12",
        "status": "A",
        "authorized_official_last_name": "TOMERLIN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-564-0100"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "5472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kori Hester Leach, LVN
• Lecelt, Inc
• Skylar Lee
• Tipton B Lee, DDS
• Kristene Amanda Leek, FNP-C
• Robert H Legrand, MD
• Caroline Lemke
• Brenden David Lemp
• Miltiadis Leon, MD
• Judy B Lepage, PT

• Skilled Nursing Facility in San Angelo, TX
• Providers in San Angelo, 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 Oct 12, 2007; 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.