Organization Active NPI

RJ Meridian Care of San Antonio III LLC

  • Skilled Nursing Facility
  • San Antonio, TX
National Provider Identifier
1760775522
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
RJ MERIDIAN CARE OF SAN ANTONIO III LLC
Practice address
815 E Grayson St
San Antonio, TX 78208-1014
Phone
(210) 827-5818
Fax
(210) 767-9560
NPI assigned
May 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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

Authorized official

Name
Alice Flores
Title
Director of Finance
Phone
(210) 827-5818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

815 E Grayson St
San Antonio, TX 78208-1014

Mailing address

25009 Oakhurst Dr
Spring, TX 77386-1975
Phone (281) 465-0636

Other identifiers 1

IdentifierTypeStateIssuer
5058MedicaidTX

Other names 1

  • Meridian Care at Grayson Square Doing business as

National Provider Directory

National Provider Directory

Locations

815 E Grayson St
San Antonio, TX 78208
Phone (210) 226-8181

NPI Registry JSON

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618444800000",
    "number": "1760775522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25009 OAKHURST DR",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773861975",
            "telephone_number": "281-465-0636",
            "fax_number": "281-465-0748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 E GRAYSON ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782081014",
            "telephone_number": "210-827-5818",
            "fax_number": "210-767-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RJ MERIDIAN CARE OF SAN ANTONIO III LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-25",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "ALICE",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "210-827-5818"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5058",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meridian Care at Grayson Square",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.