JACKSONVILLE CARE CENTER, LLC
NPI 1720512643
Assisted Living Facility in Jacksonville, AR

NPI Status: Active since April 18, 2017

Contact Information

1500 GRAHAM RD
JACKSONVILLE, AR
ZIP 72076
Phone: (501) 982-5545
Fax: (501) 982-0016

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  • Organization
  • Assisted Living Facility

About JACKSONVILLE CARE CENTER, LLC

This page provides the complete NPI Profile along with additional information for Jacksonville Care Center, Llc, a provider established in Jacksonville, Arkansas operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1720512643 assigned on April 2017. The practitioner's primary taxonomy code is 310400000X with license number 502 (AR). The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Mr. Jerry D Sams (Member)

NPI
1720512643
Provider Name
JACKSONVILLE CARE CENTER, LLC
Entity Type
Organization
Location Address
1500 GRAHAM RD JACKSONVILLE, AR 72076
Location Phone
(501) 982-5545
Location Fax
(501) 982-0016
Mailing Address
415 ROGERS AVE FORT SMITH, AR 72901
Mailing Phone
(479) 783-4672
Mailing Fax
(501) 982-0016
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-18-2017
Last Update Date
04-20-2020
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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

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
License No.
502
License State
AR
Taxonomy Description
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. JERRY D SAMS

Authorized Official Title
MEMBER
Authorized Official Phone
(479) 783-4672

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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.
1720512643
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2740101468
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 4 + 0 + 1 + 0 + 1 + 4 + 6 + 8 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 33

The NPI number 1720512643 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1073877601 MICHELLE M COLLINS
Individual
Physical Therapist1500 GRAHAM RD
JACKSONVILLE, AR 72076
(501) 920-5644

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1720512643, enumerated in the NPI registry as an "organization" on April 18, 2017

The provider is located at 1500 Graham Rd Jacksonville, Ar 72076 and the phone number is (501) 982-5545

This medical organization specializes in Assisted Living Facility with taxonomy code 310400000X

This NPI record was last updated on April 18, 2017. 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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