NPIMap

Organization Active NPI

Willowbend Health and Rehabilitation LLC

Doing business as Willowbend Health and Rehab

  • Skilled Nursing Facility
  • Marion, AR
National Provider Identifier
1053049585
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WILLOWBEND HEALTH AND REHABILITATION LLC
Doing business as
Willowbend Health and Rehab
Practice address
830 Canal St
Marion, AR 72364-5075
Phone
(870) 739-3268
NPI assigned
Aug 11, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Authorized official

Name
John Ponthie
Title
Member
Phone
(318) 216-3316

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

830 Canal St
Marion, AR 72364-5075

Mailing address

7607 Fern Ave Ste 202
Shreveport, LA 71105-5699

Other names 1

  • WILLOWBEND HEALTH AND REHAB Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230928002297 AR Part A Provider - Skilled Nursing Facility 6800240565 Practice locations: Marion, AR

Skilled nursing facility certification: CCN 045412

Legal name
WILLOWBEND HEALTH AND REHABILITATION, LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 30, 2006
Last certification
Feb 6, 2025
Beds
140
Ownership / control type
Limited Liability Corporation
Most recent change of ownership
Aug 15, 2022
Organization structure
LLCProprietary
Incorporated
Jun 14, 2022 in AR
Enrollment address
830 Canal Street
Marion, AR 72364-2505
Nursing home name
WILLOWBEND HEALTH AND REHABILITATION, LLC
Affiliated entity
SOUTHERN ADMINISTRATIVE SERVICES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Willowbend Health and Rehabilitation, LLCCCN 045412 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Apr 30, 2006
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
140110.1 residents per day on average
Chain
Southern Administrative Services35 facilities in the chain
Penalties (3 years)
3Fines totaling $30,771

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
04D1054621Willowbend Health and Rehabilitation LLC830 Canal Street, Marion, AR 72364Certificate of waiverMay 24, 2028

National Provider Directory

National Provider Directory

Locations

830 Canal St
Marion, AR 72364
Phone (870) 739-3268

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Jej Assets LP Organization, Shreveport, LA Holding company, For-profit 5% Or Greater Indirect Ownership Interest Aug 15, 2022 100%
Alexark1 LLC Organization, Shreveport, LA LLC, For-profit Operational/Managerial Control Aug 15, 2022 100%
John F Ponthie Individual 5% Or Greater Indirect Ownership Interest Aug 15, 2022 50%
General Partnership InterestAuthorized Signatory Aug 15, 2022 50%
Other Aug 15, 2023 50%
Jennifer Taylor Individual W-2 Managing EmployeeAdministrator Aug 22, 2022 100%
Sharlot Ponthie Individual 5% Or Greater Indirect Ownership Interest Aug 15, 2022 50%
4P2T1 Ops Holding LP Organization, Houston, TX Holding company, For-profit 5% Or Greater Indirect Ownership Interest Aug 15, 2022 100%

Facilities with the same owner 38

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

View all 38

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": "1660176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1053049585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7607 FERN AVE STE 202",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 CANAL ST",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723645075",
            "telephone_number": "870-739-3268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOWBEND HEALTH AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-11",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "PONTHIE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "318-216-3316"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WILLOWBEND HEALTH AND REHAB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marion, AR

Sources for this page

Verify at the official NPI Registry.