Park Bend SCC, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PARK BEND SCC, LLC

Doing business as

Park Bend SN Health Center

Practice address

2122 Park Bend Dr
Austin, TX 78758-5352

Phone

(512) 836-9777

Fax

(512) 833-9759

NPI assigned

Oct 6, 2009

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

• Park Bend SN Health Center Doing business as

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

{
    "created_epoch": "1254787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1932434198",
    "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": "2122 PARK BEND DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585352",
            "telephone_number": "512-836-9777",
            "fax_number": "512-833-9759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK BEND SCC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-06",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001017792",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Bend SN Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Park Bend SN Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael S Parish, MD
• Shaquera Jalise Parish, LPC
• Xenia Parisi, MD
• Park Bend Heal Center
• Park Bend Health Center
• Park Eyecare PLLC (Eyejoy)
• Park Infusioncare, LP
• Augustine S Park, MD
• Brandon Juyoung Park, DPT
• Catherine Park, O.D.

• Skilled Nursing Facility in Austin, TX
• Providers in Austin, 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.