Oakdale Nursing Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

OAKDALE NURSING OPCO LLC

Practice address

101 Cynthia St
Judsonia, AR 72081-9766

Phone

(501) 729-3823

Fax

(501) 729-3621

NPI assigned

May 18, 2022

Organization subpart

No

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

Authorized official

Name

Ethan Dreifus

Title

Authorized Signatory

Phone

(501) 961-8100

Specialties & licenses 1

Addresses

Other names 1

• Oakdale Nursing Facility Doing business as

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1104563410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8250",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721458250",
            "telephone_number": "501-254-0007",
            "fax_number": "888-866-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CYNTHIA ST",
            "city": "JUDSONIA",
            "state": "AR",
            "postal_code": "720819766",
            "telephone_number": "501-729-3823",
            "fax_number": "501-729-3621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKDALE NURSING OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-18",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "DREIFUS",
        "authorized_official_first_name": "ETHAN",
        "authorized_official_title_or_position": "AUTHORIZED SIGNATORY",
        "authorized_official_telephone_number": "501-961-8100"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oakdale Nursing Facility",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Oakdale Nursing Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dakota Lamp, LAC
• April D Lane, LAC
• Kendall James Lowe
• Laura Miller
• Natalie Nicole Miller
• Anna Jean Passmore, APRN, GNP-BC
• Pathtaker
• Bonnie Phillips, PH.D.
• Mallory Nicole Prior, MS, CCC-SLP
• Roger Brian Robertson

• Skilled Nursing Facility in Judsonia, AR
• Providers in Judsonia, 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 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.