Butterfield Trail Village, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

365 Issued in AR

Legal business name

BUTTERFIELD TRAIL VILLAGE, INC.

Practice address

1923 E Joyce Blvd
Fayetteville, AR 72703-5205

Phone

(479) 442-7220

Fax

(479) 442-2019

NPI assigned

Jan 18, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. William A. Wickizer

Title

Administrator

Phone

(479) 442-7220

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053464826. Details of each certification follow.

• CCN 045125 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 045125

Legal name

BUTTERFIELD TRAIL VILLAGE INC

Certification status

Active

Provider type (POS)

Nursing home – SNF (Medicare) only

Participating since

Jun 16, 1986

Last certification

Jul 11, 2024

Beds

87

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Feb 9, 1981 in AR

Enrollment address

1923 E Joyce Blvd
Fayetteville, AR 72703-5293

Nursing home name

BUTTERFIELD TRAIL VILLAGE

Listed as

Butterfield Trail VillageCCN 045125 · All quality measures

Overall star rating

3 of 5

Health inspections

3 of 5

Staffing

4 of 5

Quality measures

3 of 5

Type

Medicare

Ownership

Non profit - Corporation

Certified

Jun 16, 1986

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

8740.8 residents per day on average

Penalties (3 years)

2Fines totaling $58,006

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

All disclosed owners & managing parties 15

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Kevin Spears, OT

  • Occupational Therapist
  • Clarksdale, MS
  • NPI 1396857165
  NPD

Affiliated clinicians 6

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

• David W Clay, MD

  • Internal Medicine Physician
  • Fayetteville, AR
  • NPI 1093741910

  Nursing home

  Care Compare affiliation
• Mary N Ford, MD

  • Internal Medicine Physician
  • Fayetteville, AR
  • NPI 1356323042

  Nursing home

  Care Compare affiliation
• Christopher S Hardin, MD

  • Internal Medicine Physician
  • Fayetteville, AR
  • NPI 1811916448

  Nursing home

  Care Compare affiliation
• Arlene Urmaza Nepomuceno, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Fayetteville, AR
  • NPI 1598765208

  Nursing home

  Care Compare affiliation
• Mary Teresa Shinn, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Fayetteville, AR
  • NPI 1912957820

  Nursing home

  Care Compare affiliation
• Larry Don Wright, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Bella Vista, AR
  • NPI 1255395752

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053464826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 E JOYCE BLVD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035205",
            "telephone_number": "479-442-7220",
            "fax_number": "479-442-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 E JOYCE BLVD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035205",
            "telephone_number": "479-442-7220",
            "fax_number": "479-442-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUTTERFIELD TRAIL VILLAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WICKIZER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "479-442-7220",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William J. Burt, M.D.
• Robin Elizabeth Bush, RRT
• Chelsea Sky Butcher, LCSW
• Anna Butler, A.P.N.
• Sara Elisabeth Butler, LPC-S
• Denise Byford
• Sonja Bylak
• Travis Byram I
• Meghan Jo Byrd, MHPP
• Reba Byrd, LMSW

• Skilled Nursing Facility in Fayetteville, AR
• Providers in Fayetteville, 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 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.