CLARKSVILLE CONVALESCENT HOME
NPI 1124015680
Skilled Nursing Facility in Clarksville, AR
NPI Status: Active since September 30, 2005
Contact Information
400 OAK CT
CLARKSVILLE, AR
ZIP 72830
Phone: (479) 754-8611
Fax: (479) 754-2369
- Organization
- Skilled Nursing Facility
About CLARKSVILLE CONVALESCENT HOME
This page provides the complete NPI Profile along with additional information for Clarksville Convalescent Home, a provider established in Clarksville, Arkansas operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1124015680 assigned on September 2005. The practitioner's primary taxonomy code is 314000000X with license number 702 (AR). The provider is registered as an organization and their NPI record was last updated 17 years ago. The provider's is doing business as Clarksville Convalescent Home. The authorized official of this NPI record is Patricia Miller (President/ceo)
- NPI
- 1124015680
- Provider Legal Name
- KMJ ENTERPRISES CLARKSVILLE LLC
- Other Organization Name
- CLARKSVILLE CONVALESCENT HOME
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 400 OAK CT CLARKSVILLE, AR 72830
- Location Phone
- (479) 754-8611
- Location Fax
- (479) 754-2369
- Mailing Address
- 400 OAK CT CLARKSVILLE, AR 72830
- Mailing Phone
- (479) 754-8611
- Mailing Fax
- (479) 754-2369
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 09-30-2005
- Last Update Date
- 06-10-2008
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Skilled Nursing Facility
- Taxonomy Code
- 314000000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- 702
- License State
- AR
- Taxonomy Description
- (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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 045360 | MEDICARE OSCAR/CERTIFICATION (06) | AR | |
| 119715311 | MEDICAID (05) | AR |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 2 | 4 | 0 | 1 | 5 | 6 | 8 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 4 | 4 | 0 | 1 | 10 | 6 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 4 + 4 + 0 + 1 + 1 + 0 + 6 + 1 + 6 + 24 = 50 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1124015680 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1003064254 | CLARKSVILLE HEALTH & REHAB,LLC Organization | Skilled Nursing Facility | 400 OAK CT CLARKSVILLE, AR 72830 (479) 636-5497 |
| 1033424833 | CLARKSVILLE COMMUNITY HEALTH & REHABILITATION LLC Organization | Skilled Nursing Facility | 400 OAK CT CLARKSVILLE, AR 72830 (317) 841-2377 |
| 1235540527 | CLARKSVILLE NURSING AND REHAB, LLC Organization | Skilled Nursing Facility | 400 OAK CT CLARKSVILLE, AR 72830 (479) 754-8611 |
| 1306671243 | AMBER LEIGH GARRISON OT-A Individual | Occupational Therapy Assistant | 400 OAK CT CLARKSVILLE, AR 72830 (479) 754-9732 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124015680, enumerated in the NPI registry as an "organization" on September 30, 2005
The provider is located at 400 Oak Ct Clarksville, Ar 72830 and the phone number is (479) 754-8611
This medical organization specializes in Skilled Nursing Facility with taxonomy code 314000000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on September 30, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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