San Angelo SCC, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SAN ANGELO SCC, LLC

Doing business as

Senior Care of San Angelo

Practice address

5455 Knickerbocker Rd
San Angelo, TX 76904-7711

Phone

(325) 944-1600

Fax

(325) 944-1660

NPI assigned

May 25, 2010

Last updated

Mar 4, 2020By 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

Michael Beal

Title

Chief Executive Officer

Phone

(214) 252-7600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Senior Care of San Angelo Doing business as

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

{
    "created_epoch": "1274745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1841519295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N PEARL ST STE 1050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752017495",
            "telephone_number": "214-252-7600",
            "fax_number": "214-252-7704"
        },
        {
            "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": "SAN ANGELO SCC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-25",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "BEAL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "214-252-7600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001018594",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Senior Care of San Angelo",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Senior Care of San Angelo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• San Angelo Independent School District
• San Angelo Neurosurgical Association
• San Angelo Pediatric Associates, P.a.
• San Angelo Psychiatric Association, PLLC
• San Angelo Radiation Oncology, P.a.
• San Angelo Security Service
• San Angelo Summit Orthopedics Inc (San Angelo Summit Orthopedics)
• San Angelo Wellness Center PLLC
• San Angelo's Nutrition & Diabetic Education Center
• Jennifer Sanchez-Morales, OT

• 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 Mar 4, 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.