NPIMap

Organization Active NPI

Healthy Connections Inc

  • Federally Qualified Health Center (FQHC)
  • Malvern, AR
National Provider Identifier
1003282070
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HEALTHY CONNECTIONS INC
Practice address
900 Martin Luther King Blvd Ste 200
Malvern, AR 72104-2217
Phone
(501) 229-1487
Fax
(501) 229-1525
NPI assigned
Aug 13, 2015
Last updated
Dec 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shana Bush
Title
Credentialing Specialist
Phone
(479) 437-3449

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

900 Martin Luther King Blvd Ste 200
Malvern, AR 72104-2217

Mailing address

PO Box 1848
Mena, AR 71953-1841
Phone (479) 437-3449

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040106000555 AR Part B Supplier - Clinic/Group Practice 9931018421 Receives reassigned benefits from 59 practitioners
22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Texarkana, AR; Sheridan, AR; Russellville, AR; Mount Ida, AR; Hot Springs, AR; Mena, AR; Malvern, AR; Hot Springs Village, AR…
O20160420001361 AR Part A Provider - Federally Qualified Health Center (FQHC) 9931018421 Practice locations: Malvern, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003282070. Details of each certification follow.

Federally qualified health center certification: CCN 041915

Legal name
HEALTHY CONNECTIONS INCORPORATED
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 20, 2016
Last certification
Apr 20, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 20, 1998 in AR
Enrollment address
900 Martin Luther King Blvd
Ste 200
Malvern, AR 72104-2217

Other NPIs with the same Medicare PAC ID 18

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 18

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Steve Rook Individual Corporate DirectorBoard Member Sep 1, 2013
William a Gathright Individual Corporate DirectorChairman Mar 1, 2007
Anthony Calandro Individual Corporate OfficerChief Executive Officer Oct 4, 2010 100%
W-2 Managing EmployeeChief Executive Officer Oct 4, 2010 100%
Sherry Johnston Individual Corporate DirectorSecretary & Treasurer Feb 1, 2018
Bruce Wayne Jones Individual Corporate DirectorVice-Chairman Dec 15, 2015
Billie Holsomback Individual Corporate DirectorBoard Member Nov 1, 2018
William T Edwards Individual Corporate DirectorBoard Member Dec 1, 2011
Dalton Hopper Individual Corporate DirectorBoard Member Apr 26, 2022

All facility ownership & control disclosures 11

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Healthy Connections IncorporatedHot Springs, AR, CCN 041907 Federally qualified health center 5% Or Greater Direct Ownership Interest Feb 20, 1998
Healthy Connections IncorporatedArkadelphia, AR, CCN 041931 Federally qualified health center 5% Or Greater Direct Ownership Interest Feb 20, 1998
Healthy Connections IncorporatedHot Springs, AR, CCN 041957 Federally qualified health center 5% Or Greater Direct Ownership Interest Feb 20, 1998
Healthy Connections IncorporatedLittle Rock, AR, CCN 041962 Federally qualified health center 5% Or Greater Direct Ownership Interest Feb 20, 1998
Healthy Connections IncorporatedHot Springs Village, AR, CCN 041988 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Feb 20, 1998
Healthy Connections IncorporatedRussellville, AR, CCN 041010 Federally qualified health center 5% Or Greater Direct Ownership Interest Feb 20, 1998
Healthy Connections IncorporatedHaskell, AR, CCN 041011 Federally qualified health center 5% Or Greater Direct Ownership Interest Feb 20, 1998
Healthy Connections IncorporatedMalvern, AR, CCN 041012 Federally qualified health center 5% Or Greater Direct Ownership Interest Feb 20, 1998
Healthy Connections IncorporatedConway, AR, CCN 041026 Federally qualified health center 5% Or Greater Direct Ownership Interest Feb 20, 1998
Healthy Connections IncorporatedSheridan, AR, CCN 041030 Federally qualified health center 5% Or Greater Direct Ownership Interest Feb 20, 1998
Healthy Connections IncorporatedTexarkana, AR, CCN 041079 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Feb 20, 1998

Owned or controlled facilities with NPI records 11

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 64

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 64

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1439424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702944000000",
    "number": "1003282070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1848",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719531841",
            "telephone_number": "479-437-3449",
            "fax_number": "479-243-0285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MARTIN LUTHER KING BLVD STE 200",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721042217",
            "telephone_number": "501-229-1487",
            "fax_number": "501-229-1525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY CONNECTIONS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-13",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A",
        "authorized_official_last_name": "BUSH",
        "authorized_official_first_name": "SHANA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "479-437-3449"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malvern, AR

Sources for this page

Verify at the official NPI Registry.