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PARK PLACE NURSING & REHAB
NPI 1184954828
Nursing Facility/Intermediate Care Facility in Tyler, TX

Active since December 31, 2009CLIA 45D0680601 · Waiver
2450 E 5TH ST, TYLER, TX 75701(903) 592-6745(903) 592-1088 Get Directions Write a Review

NPPES record last updated: December 31, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Park Place Nursing & Rehab NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PARK PLACE NURSING & REHAB (NPI 1184954828) is a healthcare organization registered as a nursing facility/intermediate care facility in Tyler, Texas and active in the NPI registry since December 2009. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Sharon Kay Redd, Reimbursement Specialists, as its authorized official.

NPPES Registry Identity

NPI1184954828
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business NamePARK PLACE TYLER HC, LLC
Location Address2450 E 5TH STTyler, TX 75701-3525
Mailing Address2450 E 5th StTyler, TX 75701-3525 · (903) 592-6745 · Fax (903) 592-1088
Phone(903) 592-6745
Fax(903) 592-1088
Organization SubpartNo
Authorized OfficialSharon Kay ReddReimbursement Specialists · (903) 881-9432
Enumeration DateDecember 31, 2009
✔ NPI 1184954828 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
2450 E 5TH ST, Tyler, TX 75701
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Other Names 1

Doing Business AsPark Place Nursing & Rehab

Other Identifiers 3

Medicare UPIN676005TX
Medicaid001012142TX
Medicaid5390TX

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D0680601

Park Place Nursing & Rehabilitation Center · Tyler, TX
Active · expires Aug 31, 2026
CLIA Number45D0680601
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorMary Winters
Laboratory Phone(903) 592-6745
Laboratory LocationPark Place Nursing & Rehabilitation Center2450 East Fifth Street, Tyler, TX 75701
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. HEATHER N SMITH COTA
Occupational Therapy Assistant
2450 E 5TH ST
TYLER, TX 75701
Smith County (903) 592-6745
SOUTH PARK CARE & REHAB LLC
Skilled Nursing Facility
2450 E 5TH ST
TYLER, TX 75701
Smith County (817) 557-2221
CAROLYN ANN VIEAU
Occupational Therapy Assistant
2450 E 5TH ST
TYLER, TX 75701
Smith County (903) 592-6745
MRS. MARY GRACE SALANGA MENDOZA PTA
Physical Therapy Assistant
2450 E 5TH ST
TYLER, TX 75701
Smith County (903) 592-6745
TIFFANY GOODWYN PTA
Physical Therapy Assistant
2450 E 5TH ST
TYLER, TX 75701
Smith County (903) 592-6745
PARK PLACE TYLER HEALTHCARE, LLC
Skilled Nursing Facility
2450 E 5TH ST
TYLER, TX 75701
Smith County (903) 592-6745
HOPKINS COUNTY HOSPITAL DISTRICT
Skilled Nursing Facility
2450 E 5TH ST
TYLER, TX 75701
Smith County (972) 899-4401
REBECCA LEE ROBINSON LPTA
Physical Therapy Assistant
2450 E 5TH ST
TYLER, TX 75701
Smith County (903) 592-6745

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Park Place Tyler Hc, LLC's NPI number?

The NPI number for Park Place Tyler Hc, LLC is 1184954828. It was assigned to this organization in the NPPES registry on December 31, 2009. The provider is doing business as Park Place Nursing & Rehab.

Where is Park Place Tyler Hc, LLC located?

Park Place Tyler Hc, LLC is located at 2450 E 5th St, Tyler, TX 75701. The listed phone number is (903) 592-6745.

What is Park Place Tyler Hc, LLC's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

Does Park Place Tyler Hc, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D0680601) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Park Place Tyler Hc, LLC was last updated on December 31, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.