DERMOTT CITY NURSING HOME (NPI# 1134286750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134286750 |
| Entity Type | Organization |
| Organization Name | DERMOTT CITY NURSING HOME |
| Practice Address |
702 West Gaines St. Dermott AR 71638 |
| Mailing Address |
Po Box 710 Dermott AR 71638-0710 |
| Practice Telephone | 8705383241 |
| Practice Fax Number | 8705385763 |
| Mailing Telephone | 8705383241 |
| Mailing Fax Number | 8705385763 |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. VICKI JEAN ALLEN (ADMINISTRATOR) |
| Authorized Official Telephone | 8705385469 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 476 | AR | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | BLUE CROSS BLUE SHIELD | 15172 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DERMOTT CITY NURSING HOME | 702 W Gaines St, Dermott, AR 71638-2200 |
| Street Address |
702 WEST GAINES ST. |
| City | DERMOTT |
| State | AR |
| Zip Code | 71638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104251180 | Rebekah Ayecock | Nurse Practitioner | 300 South School St, Dermott, AR 71638 | 2013-09-09 |
| 1508198201 | Roger Alan Mason | Surgery | 300 South School St., Dermott, AR 71638 | 2010-02-04 |
| 1730219353 | Dermott Day Service Center, Inc. | Day Training, Developmentally Disabled Services | 817 North School Street, Dermott, AR 71638 | 2007-03-06 |
| 1861555005 | Dermott High School | Local Education Agency (LEA) | 525 East Speedway, Dermott, AR 71638 | 2006-12-19 |
| 1811095656 | Phillip W Pennington | Dentist | 300 S School, Dermott, AR 71638 | 2006-09-20 |
| 1669401501 | Mainline Health Systems, Inc | Clinic/Center | 134 South Strickland St, Dermott, AR 71638 | 2006-07-02 |
| 1982643409 | Jeffery Fenton Dunn Sr. | Pharmacist | 111 E Peddicord Street, Dermott, AR 71638 | 2006-06-06 |
| 1609298306 | Cb King Jm | Day Training, Developmentally Disabled Services | 1109 North School, Dermott, AR 71638-0000 | 2014-01-15 |
| 1780119610 | Medical Transport Management, Inc | Ambulance | 109 W Peddicord St, Dermott, AR 71638-2115 | 2017-04-28 |
| 1902191596 | Medical Transport Management, LLC | Ambulance | 111 W Peddicord St, Dermott, AR 71638-2115 | 2011-06-13 |
| Find all providers in zip 71638 | ||||
| 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 |
|---|---|---|---|---|
| 1558904979 | Ola Ops, Inc. | Skilled Nursing Facility | 502 W Pennington St, Ola, AR 72853-8851 | 2019-10-18 |
| 1831746676 | Cwnc Ops Inc | Skilled Nursing Facility | 1393 E Don Tyson Pkwy, Springdale, AR 72764-7882 | 2019-08-26 |
| 1881256493 | Bayshore, LLC | Skilled Nursing Facility | 260 Lakepark Dr, Hot Springs, AR 71901-9260 | 2019-07-03 |
| 1508322249 | Superior Health & Rehab LLC | Skilled Nursing Facility | 625 Tommy Lewis Dr, Conway, AR 72032-7006 | 2019-02-19 |
| 1447733480 | Chc Lakeside Nursing Center, LLC | Skilled Nursing Facility | 1207 Willow Run St, Lake City, AR 72437-9520 | 2018-09-14 |
| 1811470784 | Ltc of Berryville, LLC | Skilled Nursing Facility | 500 Hammond Avenue, Berryville, AR 72616 | 2018-09-07 |
| 1659858348 | Poplar Grove Operations LLC | Skilled Nursing Facility | 7801 Kanis Road, Little Rock, AR 72204 | 2018-07-25 |
| 1386140341 | Three Rivers Nursing and Rehabilitation LLC | Skilled Nursing Facility | 33904 Highway 63 E, Marked Tree, AR 72365-9521 | 2018-03-30 |
| 1093244097 | Salco Nc 2, Inc. | Skilled Nursing Facility | 6420 Alcoa Rd, Benton, AR 72015-6315 | 2017-06-05 |
| 1184168072 | Dierks Healthcare & Rehabilitation Center LLC | Skilled Nursing Facility | 402 S Arkansas Ave, Dierks, AR 71833-9001 | 2016-12-12 |
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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.