NPIMap

Organization Active NPI

Northport Health Services of Arkansas, LLC

  • Skilled Nursing Facility
  • Springdale, AR
National Provider Identifier
1013962018
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
594 Issued in AR
Legal business name
NORTHPORT HEALTH SERVICES OF ARKANSAS, LLC
Practice address
102 N Gutensohn Rd
Springdale, AR 72762-3801
Phone
(479) 756-0330
NPI assigned
May 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Authorized official

Name
Phillip Cody Long
Title
Cfo
Phone
(205) 391-3600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 594 AR Primary

Addresses

Primary practice location

102 N Gutensohn Rd
Springdale, AR 72762-3801

Mailing address

102 N Gutensohn Rd
Springdale, AR 72762-3801
Phone (479) 756-0330

Other identifiers 1

IdentifierTypeStateIssuer
119592311MedicaidAR

Other names 1

  • Springdale Health & Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091123000612 AR Part A Provider - Skilled Nursing Facility 6709925258 Practice locations: Springdale, AR

Skilled nursing facility certification: CCN 045167

Legal name
NORTHPORT HEALTH SERVICES OF ARKANSAS, LLC
Doing business as
SPRINGDALE HEALTH AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 17, 1991
Last certification
Aug 1, 2024
Beds
140
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Sep 29, 1997 in AR
Enrollment address
102 N Gutensohn Rd
Springdale, AR 72762-3801
Nursing home name
SPRINGDALE HEALTH AND REHABILITATION CENTER
Affiliated entity
NHS MANAGEMENT

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Springdale Health and Rehabilitation CenterCCN 045167
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jul 17, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
140112.7 residents per day on average
Chain
NHS Management43 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D0895858Springdale Health and Rehabilitation Center102 North Gutensohn, Springdale, AR 72762Certificate of waiverJul 12, 2027

National Provider Directory

National Provider Directory
Tax ID family
Northport Health Services of Arkansas LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Networks

  • devoted network organization-a90a5608-0ba5-4598-92a3-fa05df95fa3e

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
James Norman Estes Jr TR Organization, Vestavia, AL 5% Or Greater Direct Ownership Interest Dec 31, 2006 4%
Lynn S Rasco Individual Corporate DirectorDirector of Qa/Corp Compliance Ofcr Jul 1, 2022 25%
Operational/Managerial ControlDirector of Qa/Corp Compliance Ofcr Jul 1, 2022 25%
Jennifer Lee Estes TR 031093 Organization, Vestavia, AL 5% Or Greater Direct Ownership Interest Dec 31, 2006 4%
Holly M White Individual Corporate DirectorRegional Nurse Consultant Mar 4, 2022 25%
Operational/Managerial ControlRegional Nurse Consultant Mar 4, 2022 25%
James Norman Estes Individual 5% Or Greater Direct Ownership InterestPresident/Treasurer Dec 31, 2003 92%
Corporate OfficerPreasident/Treasurer Sep 29, 1997 100%
Beverly Gallagher Individual Corporate DirectorRegional Administrator Aug 21, 2023 25%
Operational/Managerial ControlRegional Administrator Aug 21, 2023 25%
Phillip Cody Long Individual Corporate OfficerVice President/Secretary Oct 1, 2019
Marcia J Moore Individual Operational/Managerial Control Aug 5, 2024
Managing Control - Governing BodyBoard Member Aug 5, 2024
Regions Bank Organization, Birmingham, AL Financial institution 5% Or Greater Security Interest Aug 27, 2013 62.31%
Stephanie Sullins Individual Operational/Managerial ControlAdministrator Jul 26, 2023 100%
Adp of the SNF Feb 3, 2025

Facilities with the same owner 40

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

View all 40

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603670400000",
    "number": "1013962018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 N GUTENSOHN RD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727623801",
            "telephone_number": "479-756-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N GUTENSOHN RD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727623801",
            "telephone_number": "479-756-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHPORT HEALTH SERVICES OF ARKANSAS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "CODY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "205-391-3600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119592311",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Springdale Health & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Springdale Health & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springdale, AR

Sources for this page

Verify at the official NPI Registry.