University Park Nursing and Rehabilitation LP

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

UNIVERSITY PARK NURSING AND REHABILITATION LP

Practice address

4511 Coronado Ave
Wichita Falls, TX 76310-2409

Phone

(940) 692-8001

Fax

(940) 692-8954

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": "1549929600000",
    "number": "1992791776",
    "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": "4511 CORONADO AVE",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763102409",
            "telephone_number": "940-692-8001",
            "fax_number": "940-692-8954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PARK NURSING AND REHABILITATION LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2019-02-12",
        "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": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001004849",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TMHP (CROSS-OVER)",
            "identifier": "1620692-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.