PRAIRIE GROVE HEALTH AND REHABILITATION (NPI# 1588833974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588833974 |
| Entity Type | Organization |
| Organization Name | PRAIRIE GROVE HEALTH AND REHABILITATION |
| Practice Address |
621 S Mock St Prairie Grove AR 72753-3146 |
| Mailing Address |
8520 S 36th Ter Fort Smith AR 72908-8880 |
| Practice Telephone | 4798462169 |
| Mailing Telephone | 4794101740 |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2012-10-24 |
| Authorized Official Name | MR. ROBERT ANDREW RYE (VICE PRESIDENT) |
| Authorized Official Telephone | 4794101740 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 853 | AR | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 166574311 | 05 |
| Street Address |
621 S MOCK ST |
| City | PRAIRIE GROVE |
| State | AR |
| Zip Code | 72753-3146 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124109749 | Sequoyah Residential Facility, Inc. | Nursing Facility/Intermediate Care Facility | 621 S Mock St, Prairie Grove, AR 72753-3146 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710465190 | Arcare | Clinic/Center | 3150 E. Heritage Parkway, Farmington, AR 72753 | 2018-07-30 |
| 1982821468 | Deborah Paas Blackburn | Speech-Language Pathologist | 15322 Goose Creek Road, Prairie Grove, AR 72753 | 2007-04-19 |
| 1083742928 | Brad Green | Dentist | 401 E Buchanan, Box 288, Prairie Grove, AR 72753 | 2007-03-01 |
| 1649332511 | Sterling Drug Company | Pharmacy | 125 E. Buchanan Street, Prairie Grove, AR 72753 | 2006-12-15 |
| 1811911100 | Andrew Thomas Bain | Dentist | 128 N Mock St, Prairie Grove, AR 72753 | 2006-07-27 |
| 1457548935 | Brad H Green Dds Pa | Dentist | 401 E Buchanan, Prairie Grove, AR 72753 | 2007-09-28 |
| 1376572800 | Ron D Lee | Family Medicine | 775 E Douglas St, Prairie Grove, AR 72753 | 2006-06-30 |
| 1376589754 | Christian G Blankers | Family Medicine | 775 E Douglas St, Prairie Grove, AR 72753 | 2006-06-22 |
| 1801350137 | Kacee Bodiford | Nurse Practitioner | 3150 E. Heritage Pwy, Prairie Grove, AR 72753-0000 | 2019-01-31 |
| 1164819330 | Tracy Houston | Specialist/Technologist | 500 Cole Dr, Prairie Grove, AR 72753-2509 | 2015-04-24 |
| Find all providers in zip 72753 | ||||
| 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 | ||||
| City | PRAIRIE GROVE |
| Zip Code | 72753 |
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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.