Active NPI
These Old Bonez Enterprises
- Personal Care Attendant
- Proctor, AR
National Provider Identifier
1063919892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- Legal business name
- THESE OLD BONEZ ENTERPRISES
- Practice address
- 2144 Hwy147 South- Building a
Proctor, AR 72376-2346 - Phone
- (870) 277-0082
- Fax
- (901) 205-0597
- NPI assigned
- Apr 9, 2018
- Last updated
- May 7, 2021
- Organization subpart
- Yes
- Parent organization
- THESE OLD BONEZ ENTERPRISES
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sherese Green
- Title
- President
- Phone
- (187) 051-4938
Specialties & licenses 14
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | NU | ||
| Home Health Agency | 251E00000X | AR | ||
| Nursing Care Agency | 251J00000X | NU | ||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | NU | ||
| Mental Illness Community Based Residential Treatment Facility | 320800000X | NU | ||
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | NU | ||
| Non-emergency Medical Transport (VAN) | 343900000X | NU | ||
| Private Vehicle | 347C00000X | NU | ||
| Personal Care Attendant | 3747P1801X | NU | Primary | |
| Respite Care | 385H00000X | NU | ||
| Respite Care | 385H00000X | AR | ||
| In Home Supportive Care Agency | 253Z00000X | NU | ||
| Local Education Agency (LEA) | 251300000X | NU | ||
| PACE Provider Organization | 251T00000X | NU |
Addresses
Primary practice location
2144 Hwy147 South- Building a
Proctor, AR 72376-2346
Mailing address
PO Box 1298
West Memphis, AR 72303-1298
Phone (870) 514-9383
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 229140797 | Medicaid | AR | |
| 33859 | Other | AR | DHS |
| 1063919892 | Medicaid | AR | |
| 232529732 | Medicaid | AR |
Other names 1
- These Old Bonez Enterprises
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | theseoldbonez17@gmail.com | Direct |
National Provider Directory
National Provider Directory- Part of
- These Old Bonez Enterprises
Practitioners & affiliated clinicians
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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Marion, AR
- NPI 1508478066
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523232000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1620345600000",
"number": "1063919892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1298",
"city": "WEST MEMPHIS",
"state": "AR",
"postal_code": "723031298",
"telephone_number": "870-514-9383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2144 HWY147 SOUTH- BUILDING A",
"city": "PROCTOR",
"state": "AR",
"postal_code": "723762346",
"telephone_number": "870-277-0082",
"fax_number": "901-205-0597"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THESE OLD BONEZ ENTERPRISES",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "THESE OLD BONEZ ENTERPRISES",
"enumeration_date": "2018-04-09",
"last_updated": "2021-05-07",
"certification_date": "2021-05-07",
"status": "A",
"authorized_official_last_name": "GREEN",
"authorized_official_first_name": "SHERESE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "187-051-4938"
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "AR",
"license": null,
"primary": false
},
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "343900000X",
"taxonomy_group": "",
"desc": "Non-emergency Medical Transport (VAN)",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": "AR",
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "251300000X",
"taxonomy_group": "",
"desc": "Local Education Agency (LEA)",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "251T00000X",
"taxonomy_group": "",
"desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "229140797",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DHS",
"identifier": "33859",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1063919892",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "232529732",
"state": "AR"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "theseoldbonez17@gmail.com",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2144 hwy147 South- Building A",
"city": "Proctor",
"state": "AR",
"country_code": "US",
"postal_code": "723762346",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "These Old Bonez Enterprises",
"code": "4",
"type": "Former Legal Business Name"
},
{
"organization_name": "These Old Bonez Enterprises",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Proctor, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.