KMJ ENTERPRISES CLARKSVILLE LLC (NPI# 1124015680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124015680 |
| Entity Type | Organization |
| Organization Name | KMJ ENTERPRISES CLARKSVILLE LLC |
| Other Organization Name | CLARKSVILLE CONVALESCENT HOME |
| Practice Address |
400 Oak Ct Clarksville AR 72830-3778 |
| Practice Telephone | 4797548611 |
| Practice Fax Number | 4797542369 |
| Mailing Telephone | 4797548611 |
| Mailing Fax Number | 4797542369 |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2008-06-10 |
| Authorized Official Name | PATRICIA MILLER (PRESIDENT/CEO) |
| Authorized Official Telephone | 4796365716 |
| Is Organization Subpart | Y |
| Parent Organization Name | KMJ MANAGEMENT |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 702 | AR | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 119715311 | 05 |
| Other Name | Type Code |
|---|---|
| Clarksville Convalescent Home | Doing Business As Name - Organization |
| Street Address |
400 OAK CT |
| City | CLARKSVILLE |
| State | AR |
| Zip Code | 72830-3778 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235540527 | Clarksville Nursing and Rehab, LLC | Skilled Nursing Facility | 400 Oak Ct, Clarksville, AR 72830-3778 | 2014-05-08 |
| 1033424833 | Clarksville Community Health & Rehabilitation LLC | Skilled Nursing Facility | 400 Oak Ct, Clarksville, AR 72830-3778 | 2010-08-17 |
| 1003064254 | Clarksville Health & Rehab,llc | Skilled Nursing Facility | 400 Oak Ct, Clarksville, AR 72830-3778 | 2008-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649737545 | Marilyn Elaine Laster | Pharmacist | 211 East Main St, Clarksville, AR 72830 | 2019-02-27 |
| 1083186431 | Kayla Chinchilla | Counselor | 106 Cherokee Lane, Clarksville, AR 72830 | 2018-12-26 |
| 1669995619 | Karla D Snow | Case Manager/Care Coordinator | 718 Brown Street, Clarksville, AR 72830 | 2017-07-21 |
| 1811426232 | Netscript Telemedicine Solutions | Family Medicine | 235 Cr 3520, Clarksville, AR 72830 | 2017-06-08 |
| 1275882060 | Shay Morgan | Dietitian, Registered | 1100 East Poplar Street, Clarksville, AR 72830 | 2012-09-07 |
| 1518111566 | Melisa Leann Traylor | Case Manager/Care Coordinator | 522 Mill Road, Clarksville, AR 72830 | 2008-11-04 |
| 1669635280 | Family Foot Clinic | Podiatrist | 203 Sevier St, Clarksville, AR 72830 | 2008-07-03 |
| 1891969721 | Scott Lee Landis | Counselor | 522 Mills Rd., Clarksville, Ar, AR 72830 | 2008-04-22 |
| 1437364684 | Snider Family Chiropractic Clinic | Chiropractor | 1012 Poplar St., Clarksville, AR 72830 | 2007-05-11 |
| 1376765917 | Jones Speech Therapy | Speech-Language Pathologist | 1312 North Harmony Road, Clarksville, AR 72830 | 2007-05-03 |
| Find all providers in zip 72830 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831691922 | Fpacp Clarksville LLC | Skilled Nursing Facility | 2407 West Main Highway 82, Clarksville, TX 75426 | 2018-03-05 |
| 1528448974 | Tennessee State Veterans Home Board | Skilled Nursing Facility | 250 Arrowood Drive, Clarksville, TN 37042 | 2015-06-01 |
| 1962838748 | Rehab America | Skilled Nursing Facility | 900 Professional Park, Clarksville, TN 37040-0000 | 2013-09-24 |
| 1437593811 | Johnson County Health and Rehab, LLC | Skilled Nursing Facility | 1451 East Poplar St, Clarksville, AR 72830-0000 | 2013-04-29 |
| 1669640272 | Donna L Carron | Skilled Nursing Facility | 198 Farmer Rd, Clarksville, TN 37043-7010 | 2008-02-16 |
| 1891985131 | Lp Clarksville LLC | Skilled Nursing Facility | 198 Old Farmers Rd, Clarksville, TN 37043-4032 | 2007-08-01 |
| 1598837486 | Indiana Health & Rehabilitation Centers | Skilled Nursing Facility | 517 N Hallmark Dr, Clarksville, IN 47129-6629 | 2006-11-15 |
| 1477595775 | Integrity Healthcare of Clarksville, LLC | Skilled Nursing Facility | 111 Ussery Rd, Clarksville, TN 37043-4530 | 2006-06-12 |
| 1699736421 | Nexion Health At Bogata, Inc. | Skilled Nursing Facility | 2407 W Main St, Clarksville, TX 75426-3327 | 2006-03-31 |
| 1205823697 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 586 Eastern Blvd, Clarksville, IN 47129 | 2005-09-30 |
| Find all providers in CLARKSVILLE | ||||
| City | CLARKSVILLE |
| Zip Code | 72830 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.