NPIMap

Organization Active NPI

LTC of Jacksonville, LLC

  • Skilled Nursing Facility
  • Jacksonville, AR
National Provider Identifier
1013490986
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LTC OF JACKSONVILLE, LLC
Practice address
1320 Braden St
Jacksonville, AR 72076-3719
Phone
(501) 241-2191
NPI assigned
Sep 7, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Authorized official

Name
Carla Hedrick, CFO
Title
Cfo
Phone
(573) 481-9625

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1320 Braden St
Jacksonville, AR 72076-3719

Mailing address

1320 Braden St
Jacksonville, AR 72076-3719
Phone (501) 241-2191

Other names 1

  • Woodland Hills Healthcare and Rehabilitation Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL 199.119.81.30:8291 Other eSolutions Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181031001314 AR Part A Provider - Skilled Nursing Facility 2466705975 Practice locations: Jacksonville, AR

Skilled nursing facility certification: CCN 045378

Legal name
LTC OF JACKSONVILLE, LLC
Doing business as
WOODLAND HILLS HEALTHCARE AND REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 1, 2002
Last certification
Dec 18, 2024
Beds
120
Ownership / control type
Limited Liability Corporation
Most recent change of ownership
Jul 1, 2018
Organization structure
LLCProprietary
Incorporated
Jun 1, 2018 in MO
Enrollment address
1320 Braden St
Jacksonville, AR 72076-3719
Nursing home name
WOODLAND HILLS HEALTHCARE AND REHABILITATION
Affiliated entity
JAMES & JUDY LINCOLN

Care Compare: Nursing home

Medicare Care Compare
Listed as
Woodland Hills Healthcare and RehabilitationCCN 045378
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Nov 1, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12053.2 residents per day on average
Chain
James & Judy Lincoln56 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

1320 Braden St
Jacksonville, AR 72076
Phone (501) 241-2191

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Timothy O Drake Individual Contracted Managing EmployeeManager of a Manager Managed LLC Mar 22, 2022 100%
Corporate OfficerPresident Mar 28, 2022 100%
LTC Management Services LLC Organization, Sikeston, MO Management services company Operational/Managerial Control Jun 1, 2018 100%
James C Lincoln Individual 5% Or Greater Direct Ownership Interest Jun 1, 2018 50%
Judy L Lincoln Individual 5% Or Greater Direct Ownership Interest Jun 1, 2018 50%

Facilities with the same owner 36

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 36

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1536278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761177600000",
    "number": "1013490986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 BRADEN ST",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720763719",
            "telephone_number": "501-241-2191",
            "fax_number": "501-241-2197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 BRADEN ST",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720763719",
            "telephone_number": "501-241-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LTC OF JACKSONVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-07",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A",
        "authorized_official_last_name": "HEDRICK",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "573-481-9625",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "199.119.81.30:8291",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 w 108th ter",
            "city": "overland park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Woodland Hills Healthcare and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Woodland Hills Healthcare and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, AR

Sources for this page

Verify at the official NPI Registry.