NPIMap

Organization Active NPI

Heartway III Corporation

Doing business as Avalon Place-Wharton

  • Skilled Nursing Facility
  • Wharton, TX
National Provider Identifier
1972581882
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
112200 Issued in TX
Legal business name
HEARTWAY III CORPORATION
Doing business as
Avalon Place-Wharton
Practice address
1405 Valhalla Dr
Wharton, TX 77488-9218
Phone
(979) 532-1244
Fax
(979) 532-1142
NPI assigned
Jan 3, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. David T. Obergfell
Title
President, Board of Directors
Phone
(214) 777-0282

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 112200 TX Primary

Addresses

Primary practice location

1405 Valhalla Dr
Wharton, TX 77488-9218

Mailing address

1405 Valhalla Dr
Wharton, TX 77488-9218
Phone (979) 532-1244

Other names 1

  • Avalon Place-Wharton Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Avalon Place - Kirbyville3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972581882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 VALHALLA DR",
            "city": "WHARTON",
            "state": "TX",
            "postal_code": "774889218",
            "telephone_number": "979-532-1244",
            "fax_number": "979-532-1142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 VALHALLA DR",
            "city": "WHARTON",
            "state": "TX",
            "postal_code": "774889218",
            "telephone_number": "979-532-1244",
            "fax_number": "979-532-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTWAY III CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OBERGFELL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT, BOARD OF DIRECTORS",
        "authorized_official_telephone_number": "214-777-0282",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "112200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avalon Place-Wharton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wharton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.