JERRY DANIEL MULLIN (NPI# 1396964557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396964557 |
| Entity Type | Individual |
| Full Name | JERRY DANIEL MULLIN |
| Credential | OTR |
| Practice Address |
741 South Drive Mt. Ida AR 71957 |
| Mailing Address |
2595 Highway 270 E Mount Ida AR 71957-8066 |
| Practice Telephone | 8708672156 |
| Practice Fax Number | 8708672584 |
| Mailing Telephone | 8708674625 |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 196 | AR | Nursing & Custodial Care Facilities |
| Street Address |
741 SOUTH DRIVE |
| City | MT. IDA |
| State | AR |
| Zip Code | 71957 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619326881 | Wagner Drugs, Inc. | Pharmacy | 744 Hwy 270 East, Mount Ida, AR 71957 | 2016-06-08 |
| 1245699636 | Seeking Serenity Holistic Therapy Center | Social Worker | 506 Hwy 270 E, Mt.ida, AR 71957 | 2016-02-15 |
| 1518368562 | Village Apothecary, Inc. | Durable Medical Equipment & Medical Supplies | 136 S George Street, Mt Ida, AR 71957 | 2014-09-09 |
| 1306276217 | Compleat Rehab and Sports Therapy Center(satellite Branch)of Jordan Pt | Physical Therapist | 135 South East Street, Mt.ida, AR 71957 | 2013-11-14 |
| 1265871370 | Barbara E Page | Veterinarian | 317 North George St, Mount Ida, AR 71957 | 2013-06-21 |
| 1609079102 | Cynthia Jean Crowson | Social Worker | 506 Highway 270 East, Mt. Ida, AR 71957 | 2007-06-11 |
| 1124229794 | David P Hochstedler | Physical Therapist | 741 South Dr, Mt. Ida, AR 71957 | 2007-05-30 |
| 1386864791 | Samantha Dawn Ashford | Physical Therapy Assistant | 741 S Drive, Mount Ida, AR 71957 | 2007-04-26 |
| 1861585002 | City Drug and Soda Fountain | Durable Medical Equipment & Medical Supplies | 121 W S West Street, Mount Ida, AR 71957 | 2006-10-02 |
| 1659381705 | State of Arkansas | Home Health | 346 Luzerne, Montgomery County Health Unit, Mount Ida, AR 71957 | 2006-08-09 |
| Find all providers in zip 71957 | ||||
| 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 |
| Find all providers with the same taxonomy | ||||
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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.