NPIMap

Organization Active NPI

Yellville Healthcare LLC

  • Skilled Nursing Facility
  • Yellville, AR
National Provider Identifier
1073260774
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
YELLVILLE HEALTHCARE LLC
Practice address
620 N Panther Ave
Yellville, AR 72687-9313
Phone
(870) 449-4201
NPI assigned
Mar 3, 2022
Last updated
Mar 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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

Authorized official

Name
Jacob Taub
Title
Authorized Rep
Phone
(718) 838-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

620 N Panther Ave
Yellville, AR 72687-9313

Mailing address

362 E Kennedy Blvd
Lakewood, NJ 08701-1434

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230130000271 AR Part A Provider - Skilled Nursing Facility 1850762865 Practice locations: Yellville, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073260774. Details of each certification follow.

Skilled nursing facility certification: CCN 045451

Legal name
YELLVILLE HEALTHCARE LLC
Doing business as
CREEKSIDE AT THE SPRINGS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 15, 2012
Last certification
May 15, 2025
Beds
96
Ownership / control type
Limited Liability Corporation
Most recent change of ownership
Mar 31, 2022
Organization structure
LLCProprietary
Incorporated
Jul 13, 2021 in AR
Enrollment address
620 N Panther Avenue
Yellville, AR 72687-9313
Nursing home name
CREEKSIDE AT THE SPRINGS
Affiliated entity
THE SPRINGS ARKANSAS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Creekside at the SpringsCCN 045451 · 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
Dec 15, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9678.5 residents per day on average
Chain
The Springs Arkansas26 facilities in the chain
Penalties (3 years)
1Fines totaling $15,915

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Richard B Chitsey Individual Operational/Managerial Control Mar 31, 2022
Adp of the SNF Mar 31, 2022
Yellville Realty Holdings LLC Organization, Lakewood, NJ LLC, Holding company Adp of the SNF Mar 31, 2022
Black River Healthcare LLC Organization, Lakewood, NJ LLC, Management services company Operational/Managerial Control Mar 31, 2022
Adp of the SNF May 16, 2025
Isaac Gutman Individual 5% Or Greater Direct Ownership Interest Mar 31, 2022 28.33%
Jacob Taub Individual 5% Or Greater Direct Ownership Interest Mar 31, 2022 28.33%
Alexander Hoffman Individual 5% Or Greater Direct Ownership Interest Mar 31, 2022 28.33%
Chaim Y Herzberg Individual 5% Or Greater Direct Ownership Interest Mar 31, 2022 15%
Shelli Casey Individual Operational/Managerial Control Mar 31, 2022
Adp of the SNF Mar 31, 2022

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 5

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

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1646265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646265600000",
    "number": "1073260774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 E KENNEDY BLVD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087011434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N PANTHER AVE",
            "city": "YELLVILLE",
            "state": "AR",
            "postal_code": "726879313",
            "telephone_number": "870-449-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YELLVILLE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-03",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A",
        "authorized_official_last_name": "TAUB",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "AUTHORIZED REP",
        "authorized_official_telephone_number": "718-838-1500"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yellville, AR

Sources for this page

Verify at the official NPI Registry.