NPIMap

Organization Active NPI

Magnolia Regional Medical Center

  • Home Health Agency
  • Magnolia, AR
National Provider Identifier
1093736753
Registry record updated Jan 17, 2017
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Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
AR4240 Issued in AR
Legal business name
MAGNOLIA REGIONAL MEDICAL CENTER
Practice address
833 N Washington
Magnolia, AR 71753
Phone
(870) 235-3598
Fax
(870) 235-3677
NPI assigned
Jul 21, 2006
Last updated
Jan 17, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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

Authorized official

Name
Mr. Rex E Jones
Title
Chief Executive Officer
Phone
(870) 235-3212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X AR4240 AR Primary

Addresses

Primary practice location

833 N Washington
Magnolia, AR 71753

Mailing address

PO Box 629
Magnolia, AR 71754-0629
Phone (870) 235-3598

Other identifiers 2

IdentifierTypeStateIssuer
17081OtherARABCBS
101604514MedicaidAR

Other names 1

  • Magnolia Home Health Agency Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Oct 1, 2020 Change of OwnershipThis provider was the seller Magnolia Home Health AgencyCCN 047081, AR, NPI 1336760362

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484611200000",
    "number": "1093736753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 629",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717540629",
            "telephone_number": "870-235-3598",
            "fax_number": "870-235-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 N WASHINGTON",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "71753",
            "telephone_number": "870-235-3598",
            "fax_number": "870-235-3677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2017-01-17",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "REX",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "870-235-3212",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AR",
            "license": "AR4240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ABCBS",
            "identifier": "17081",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101604514",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Home Health Agency",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Magnolia, AR

Sources for this page

Verify at the official NPI Registry.