Legend Oaks - South San Antonio, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

5487 Issued in TX

Legal business name

LEGEND OAKS - SOUTH SAN ANTONIO, LLC

Doing business as

Legend Oaks Healthcare and Rehabilitation Center - San Antonio

Practice address

2003 W. Hutchins PL
San Antonio, TX 78224-1368

Phone

(210) 927-0827

Fax

(210) 927-0806

NPI assigned

Jul 25, 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

Other identifiers 1

Other names 1

• Legend Oaks Healthcare and Rehabilitation Center - San Antonio Doing business as

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427328000000",
    "number": "1871516609",
    "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",
            "telephone_number": "210-564-0100",
            "fax_number": "210-564-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 W. HUTCHINS PL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782241368",
            "telephone_number": "210-927-0827",
            "fax_number": "210-927-0806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGEND OAKS - SOUTH SAN ANTONIO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2015-03-26",
        "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": "5487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001014458",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legend Oaks Healthcare and Rehabilitation Center - San Antonio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in San Antonio, TX
• Providers in San Antonio, 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 26, 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.