Wood Memorial Hospital & Nursing Home Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

108653 Issued in TX

Legal business name

WOOD MEMORIAL HOSPITAL & NURSING HOME INC

Doing business as

Wood Memorial Nursing Home

Practice address

320 Greenville Ave
Mineola, TX 75773-1032

Phone

(903) 569-9023

Fax

(903) 569-3852

NPI assigned

May 24, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Stephen Cohen

Title

Vice President

Phone

(903) 569-9023

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• WOOD MEMORIAL NURSING HOME Doing business as

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288828800000",
    "number": "1912900747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 GREENVILLE AVE",
            "city": "MINEOLA",
            "state": "TX",
            "postal_code": "757731032",
            "telephone_number": "903-569-3852",
            "fax_number": "903-569-1168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 GREENVILLE AVE",
            "city": "MINEOLA",
            "state": "TX",
            "postal_code": "757731032",
            "telephone_number": "903-569-9023",
            "fax_number": "903-569-3852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOOD MEMORIAL HOSPITAL & NURSING HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2010-11-04",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "903-569-9023",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "108653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "094182501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00439602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WOOD MEMORIAL NURSING HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kyle Ernest Weedon, DDS
• Dan Riddle White, D.D.S.
• Heather Williams, PTA
• Rhonda M Williams
• Shelia D Williams, FNP
• Jeffrey Bryan Yarbrough, FNP-C

• Skilled Nursing Facility in Mineola, TX
• Providers in Mineola, 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 Nov 4, 2010; 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.