Legend Oaks - Granite Mesa, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

LEGEND OAKS - GRANITE MESA, LLC

Doing business as

Granite Mesa Health Center

Practice address

1401 Max Copeland Dr
Marble Falls, TX 78654-4665

Phone

(830) 693-0022

NPI assigned

Oct 23, 2013

Last updated

Mar 25, 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

Thomas Martin Tomerlin

Title

President/Coo/Manager

Phone

(210) 564-0100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Granite Mesa Health Center Doing business as

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427241600000",
    "number": "1750719068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 E BITTERS RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782162914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MAX COPELAND DR",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "786544665",
            "telephone_number": "830-693-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGEND OAKS - GRANITE MESA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-23",
        "last_updated": "2015-03-25",
        "status": "A",
        "authorized_official_last_name": "TOMERLIN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT/COO/MANAGER",
        "authorized_official_telephone_number": "210-564-0100"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001025552",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Granite Mesa Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lela Lankerani, D.O.
• Kellyn June Lappinga
• Laurence Robert Bower III (MRI Now - Marble Falls)
• Connie Sue Lavoie, D.C.
• Jack F. Lay Jr., M.D.
• Tashi Bascon Lekkala, MD
• Maya Pramod Lele, M.D.
• Scott Liggett, MD
• Geraldo Alberto Lim
• Christine Pao-Ling Lin

• Skilled Nursing Facility in Marble Falls, TX
• Providers in Marble Falls, 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 Mar 25, 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.