Russellville Holdings, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

RUSSELLVILLE HOLDINGS, LLC

Practice address

11720 State Route 27
Hector, AR 72843

Phone

(479) 284-5001

NPI assigned

Aug 24, 2007

Organization subpart

Yes

Parent organization

RUSSELLVILLE HOLDINGS, LLCAs reported in NPPES

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

Authorized official

Name

Terrance Dillon

Title

Assistant Secretary

Phone

(502) 596-7220

Specialties & licenses 1

Addresses

Other names 1

• (Part B) Other name

Tax ID family

Russellville Holdings LLC2 organizations share this tax ID, including this one

Part of

Russellville Holdings LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Russellville Holdings LLC

  dba Saint Mary's Regional Medical Center Rehab

  • Rehabilitation Hospital Unit
  • Russellville, AR
  • NPI 1376595132
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Russellville Holdings LLC

  dba St . Mary's Regional Medical Center

  • General Acute Care Hospital
  • Russellville, AR
  • NPI 1033160049
  NPPES parent name

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648512000000",
    "number": "1013100890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 MERIDIAN BLVD",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370676325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11720 STATE ROUTE 27",
            "city": "HECTOR",
            "state": "AR",
            "postal_code": "72843",
            "telephone_number": "479-284-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELLVILLE HOLDINGS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RUSSELLVILLE HOLDINGS, LLC",
        "enumeration_date": "2007-08-24",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A",
        "authorized_official_last_name": "DILLON",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "502-596-7220"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "(Part B)",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "(Part B)",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Hector Pharmacy, Inc. (Hector Pharmacy)
• Hector School
• Jessica Louise Mearns
• Karlee D Rudder
• Russellville Holdings LLC (Valley Health Services of Hector)
• Ashley Dawn Shrives, APRN
• Talk Time LLC
• Total Family Medical, LLC (Total Family Medical at White Oak)
• White Oak Medical Clinic
• Jimmy Lee Womack Jr., APRN FNP-C

• General Practice Physician in Hector, AR
• Providers in Hector, AR by specialty
• General Practice Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.