DIVERSICARE PINEDALE, LLC (NPI# 1922096593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922096593 |
| Entity Type | Organization |
| Organization Name | DIVERSICARE PINEDALE, LLC |
| Other Organization Name | NEWPORT HEALTHCARE AND REHABILITATION CENTER |
| Practice Address |
1311 N Pecan St Newport AR 72112-2816 |
| Practice Telephone | 8705239514 |
| Practice Fax Number | 8705238198 |
| Mailing Telephone | 8705239514 |
| Mailing Fax Number | 8705238198 |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | RAYMOND L. TYLER JR. (EXECUTIVE VICE PRESIDENT AND COO) |
| Authorized Official Telephone | 6157717575 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 654 | AR | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Newport Healthcare and Rehabilitation Center | Doing Business As Name - Organization |
| Street Address |
1311 N PECAN ST |
| City | NEWPORT |
| State | AR |
| Zip Code | 72112-2816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972074300 | Michael Holmes | Occupational Therapy Assistant | 1311 N Pecan St, Newport, AR 72112-2816 | 2018-12-11 |
| 1720561699 | Ltc of Newport, LLC | Skilled Nursing Facility | 1311 N Pecan St, Newport, AR 72112-2816 | 2018-09-07 |
| 1740537356 | St. Michael's Place, Inc. | Skilled Nursing Facility | 1311 N Pecan St, Newport, AR 72112-2816 | 2012-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447749437 | Amie Burrow | Nurse Practitioner | 300 Corrections Drive, Newport, AR 72112 | 2018-05-04 |
| 1780120691 | Rx Hound Inc | Pharmacy | 1117 Mclain St Ste 400, Newport, AR 72112 | 2017-01-17 |
| 1285188789 | Jasmine Mansko | Speech-Language Pathologist | 1128 S Main St, Newport, AR 72112 | 2016-08-12 |
| 1366831877 | Madison Eddington | Physical Therapy Assistant | 1807 Jetta Drive, Newport, AR 72112 | 2015-01-21 |
| 1750514840 | Ralph Irwin Wray | Counselor | 107 Laurel St, Newport, AR 72112 | 2009-08-24 |
| 1952558264 | Maxus Inc | Counselor | 2000 Mclain, Suite B, Newport, AR 72112 | 2008-08-19 |
| 1275748725 | Troy Larry Vincent Sr. | Counselor | 1507 N. Pecan St., Newport, AR 72112 | 2007-05-10 |
| 1114065083 | Deanna Dawn Browning | Case Manager/Care Coordinator | 1509 N Pecan St, Newport, AR 72112 | 2007-02-02 |
| 1295895670 | Allene Cummings | Social Worker | 1507 North Pecan Street, Newport, AR 72112 | 2006-12-08 |
| 1295801207 | Brandy Diane Young | Speech-Language Pathologist | 221 Lindley Lane, Newport, AR 72112 | 2006-11-28 |
| Find all providers in zip 72112 | ||||
| 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 |
|---|---|---|---|---|
| 1679739445 | Lisa Lyn Shover | Skilled Nursing Facility | 63 Spring St, Newport, VT 05855-5819 | 2008-07-31 |
| 1972691178 | Silver Corporation | Skilled Nursing Facility | 148 Prouty Dr, Newport, VT 05855-9513 | 2006-10-11 |
| 1730106774 | Newport Rehabilitation, Inc. | Skilled Nursing Facility | 835 Sw 11th St, Newport, OR 97365-4802 | 2006-07-16 |
| 1942236161 | River Neuse Group, LLC | Skilled Nursing Facility | 210 Foxhall Rd, Newport, NC 28570-6790 | 2006-06-23 |
| 1568416964 | Lindley Healthcare, LLC | Skilled Nursing Facility | 326 Lindley Ln, Newport, AR 72112-4948 | 2006-05-20 |
| 1407800089 | Southwest Homes | Skilled Nursing Facility | 1005 Mclain St, Newport, AR 72112-3529 | 2006-05-19 |
| 1902887029 | Heatherwood Nursing and Rehabilitation Center Inc | Skilled Nursing Facility | 398 Bellevue Ave, Newport, RI 02840 | 2005-11-07 |
| 1508854886 | Greenleaf Properties, Inc | Skilled Nursing Facility | 84 Pine St, Newport, NH 03773-2005 | 2005-10-11 |
| 1174091664 | Bearmt Newport, LLC | Skilled Nursing Facility | 148 Prouty Dr, Newport, VT 05855-9513 | 2018-11-02 |
| 1609350172 | Waters of Newport LLC | Skilled Nursing Facility | 326 Lindley Ln, Newport, AR 72112-4948 | 2018-09-20 |
| Find all providers in NEWPORT | ||||
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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.