Marine Creek Nursing and Rehabilitation LP

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MARINE CREEK NURSING AND REHABILITATION LP

Practice address

3600 Angle Ave
Fort Worth, TX 76106-3559

Phone

(817) 624-6164

Fax

(817) 624-7523

NPI assigned

Sep 27, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Dan D. Flagg

Title

Ceo

Phone

(940) 387-4388

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548806400000",
    "number": "1871589648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 S ELM ST",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762016085",
            "telephone_number": "940-387-4388",
            "fax_number": "940-380-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 ANGLE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761063559",
            "telephone_number": "817-624-6164",
            "fax_number": "817-624-7523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINE CREEK NURSING AND REHABILITATION LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2019-01-30",
        "status": "A",
        "authorized_official_last_name": "FLAGG",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "940-387-4388",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TMHP (CROSSOVER)",
            "identifier": "163345501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01004880",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine D Marczyk Organek, PHD
• Alyssa Danielle Marek, DO
• Theodore Edward Margo, M.D.
• Linda Russell Margraf, MD
• Marian Medical Transportation LLC
• Philip Vincent Marinelli, DO
• Karina Marino, LPC-A
• Nancy Maritim
• Mark Garza, M.D., PLLC
• Mark Garza, M.D., PLLC

• Skilled Nursing Facility in Fort Worth, TX
• Providers in Fort Worth, 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 Jan 30, 2019; 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.