Pine Hill Nursing and Rehabilitation LP

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

114787 Issued in TX

Legal business name

PINE HILL NURSING AND REHABILITATION LP

Practice address

1307 Martin Luther King Dr
Jefferson, TX 75657-1009

Phone

(903) 665-3951

Fax

(903) 665-7230

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. Michael A Rich

Title

President

Phone

(940) 387-4388

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216857600000",
    "number": "1952397739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N ELM ST",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762014137",
            "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": "1307 MARTIN LUTHER KING DR",
            "city": "JEFFERSON",
            "state": "TX",
            "postal_code": "756571009",
            "telephone_number": "903-665-3951",
            "fax_number": "903-665-7230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE HILL NURSING AND REHABILITATION LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2008-07-24",
        "status": "A",
        "authorized_official_last_name": "RICH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "940-387-4388",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "114787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001004238",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TMHP DME CROSS OVER",
            "identifier": "153325901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TMHP CROSS OVER",
            "identifier": "153385101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Molly Pylant, LVN

• All providers in Jefferson, TX
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; 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.