NPIMap

Organization Active NPI

Country Inn Healthcare

  • Skilled Nursing Facility
  • Van, TX
National Provider Identifier
1811985617
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
4299 Issued in TX
Legal business name
COUNTRY INN HEALTHCARE
Practice address
1085 E Main St
Van, TX 75790-2949
Phone
(903) 963-8646
NPI assigned
Oct 6, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Wyvonne Pitts
Title
Administrator
Phone
(903) 963-8646

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 4299 TX Primary

Addresses

Primary practice location

1085 E Main St
Van, TX 75790-2949

Mailing address

1085 E Main St
Van, TX 75790-2949

National Provider Directory

National Provider Directory
Tax ID family
Sweetwater Health Care Center28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811985617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1085 E MAIN ST",
            "city": "VAN",
            "state": "TX",
            "postal_code": "757902949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1085 E MAIN ST",
            "city": "VAN",
            "state": "TX",
            "postal_code": "757902949",
            "telephone_number": "903-963-8646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY INN HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PITTS",
        "authorized_official_first_name": "WYVONNE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "903-963-8646"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "4299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.