KMJ ENTERPRISES MOUNTAIN HOME LLC (NPI# 1871580076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871580076 |
| Entity Type | Organization |
| Organization Name | KMJ ENTERPRISES MOUNTAIN HOME LLC |
| Other Organization Name | PINE LANE HEALTHCARE |
| Practice Address |
1100 Pine Tree Ln Mountain Home AR 72653-4502 |
| Practice Telephone | 8704256316 |
| Practice Fax Number | 8704245197 |
| Mailing Telephone | 8704256316 |
| Mailing Fax Number | 8704245197 |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2008-06-13 |
| 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 | 720 | AR | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 119728311 | 05 |
| Other Name | Type Code |
|---|---|
| Pine Lane Healthcare | Doing Business As Name - Organization |
| Street Address |
1100 PINE TREE LN |
| City | MOUNTAIN HOME |
| State | AR |
| Zip Code | 72653-4502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619513934 | Maranda Hickman | Physical Therapy Assistant | 347 Hwy 62 East College Plaza, Mountain Home, AR 72653 | 2019-11-21 |
| 1659929156 | Gale E Bacan | Technician | 1703 Monroe Ave, Mountain Home, AR 72653 | 2019-08-28 |
| 1891259321 | Kidspiration Pediatric Therapy Services | Clinic/Center | 710 Bradley Dr., Mountain Home, AR 72653 | 2019-01-29 |
| 1093279275 | Piper's Vision Xpress, LLC | Optometrist | 50 Paul Wood Lane, Mountian Home, AR 72653 | 2019-01-22 |
| 1346769155 | Heather Bollinger | Nurse Practitioner | 65 Walmart Drive, C/o Clinic At Walmart, Mountain Home, AR 72653 | 2017-09-12 |
| 1447774989 | Natalie D Ahrent | Physical Medicine & Rehabilitation | 804 Coley Dr, Mountain Home, AR 72653 | 2017-07-26 |
| 1417486028 | Andrew David Hatman | Case Manager/Care Coordinator | 1349 Hampshire Circle, Mountain Home, AR 72653 | 2017-06-07 |
| 1568848315 | Taylor Chiropractic Plc | Health Maintenance Organization | 103 S Main St Ste 5, Mountain Home, AR 72653 | 2015-08-04 |
| 1942606306 | Harps Food Stores, Inc | Pharmacy | 2089 Highway 62 West, Mountain Home, AR 72653 | 2014-11-13 |
| 1972920726 | Lavonne Armstrong | Counselor | 8 Medical Plaza, Mountain Home, AR 72653 | 2014-03-18 |
| Find all providers in zip 72653 | ||||
| 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 |
|---|---|---|---|---|
| 1871812099 | Pine Lane Therapy and Living Center, Inc. | Skilled Nursing Facility | 1100 Pinetree Ln, Mountain Home, AR 72653-4502 | 2010-05-27 |
| 1194822585 | Baxter County Nursing Facility, Inc. | Skilled Nursing Facility | 3545 Hwy 5 N, Mountain Home, AR 72653 | 2006-09-20 |
| 1609864537 | Cmnrc, Inc. | Skilled Nursing Facility | 804 Burnett Dr, Mountain Home, AR 72653-2939 | 2005-10-13 |
| 1538157466 | Bmnrc, Inc. | Skilled Nursing Facility | 620 Hospital Dr, Mountain Home, AR 72653-2915 | 2005-10-13 |
| 1184620791 | Elmore Medical Center Hospital District | Skilled Nursing Facility | 895 N 6th E, Mountain Home, ID 83647-2207 | 2005-06-28 |
| 1225454325 | Mhpnc, Inc. | Skilled Nursing Facility | 1100 Pinetree Ln, Mountain Home, AR 72653-4502 | 2014-03-13 |
| 1376969931 | Mhcnc, Inc. | Skilled Nursing Facility | 804 Burnett Dr, Mountain Home, AR 72653-2939 | 2014-03-06 |
| 1790101368 | Mhhnc, Inc | Skilled Nursing Facility | 620 Hospital Dr, Mountain Home, AR 72653-2915 | 2014-03-06 |
| 1508105248 | St Lukes Regional Medical Center | Skilled Nursing Facility | 895 N 6th E, Mountain Home, ID 83647-2207 | 2013-01-31 |
| 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 | MOUNTAIN HOME |
| Zip Code | 72653 |
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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.