Willow Ridge Nursing and Rehabilitation, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

WILLOW RIDGE NURSING AND REHABILITATION, LLC

Practice address

3855 Benton Pkwy
Benton, AR 72015-8500

Phone

(501) 575-0137

NPI assigned

Aug 12, 2025

Organization subpart

No

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

Authorized official

Name

Rodney Dean

Title

Secretary

Phone

(479) 783-4672

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1754956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787097600000",
    "number": "1033095591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729011903",
            "telephone_number": "479-783-4672",
            "fax_number": "479-783-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 BENTON PKWY",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720158500",
            "telephone_number": "501-575-0137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW RIDGE NURSING AND REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-12",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "479-783-4672"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Willingham, RECOVERY ASSISTANT
• Jason Willis, RECOVERY ASSISTANT
• Laquita Shana Willis, MSW, LCSW
• Laura Willis
• Tabitha Willis, CMP
• Alesia Wilson, RECOVERY ASSISTANT
• Antoinette Wilson, RECOVERY ASSISTANT
• Heidi Wilson
• Kelsey Wilson
• Kendra Wilson, APRN

• Skilled Nursing Facility in Benton, AR
• Providers in Benton, AR by specialty
• Skilled Nursing Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.