Short Mountain Lodge Residential Care

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

SHORT MOUNTAIN LODGE RESIDENTIAL CARE

Practice address

2721 W Walnut St
Paris, AR 72855-3642

Phone

(479) 963-2255

NPI assigned

Mar 6, 2019

Last updated

Mar 6, 2019By 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

Linda Short

Title

Owner

Phone

(479) 452-4949

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551830400000",
    "number": "1114485471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2721 W WALNUT ST",
            "city": "PARIS",
            "state": "AR",
            "postal_code": "728553642",
            "telephone_number": "479-963-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2721 W WALNUT ST",
            "city": "PARIS",
            "state": "AR",
            "postal_code": "728553642",
            "telephone_number": "479-963-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORT MOUNTAIN LODGE RESIDENTIAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-06",
        "last_updated": "2019-03-06",
        "status": "A",
        "authorized_official_last_name": "SHORT",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-452-4949"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose Drug Paris Inc (Rose Drug of Paris)
• Jessica Michelle Russell, APRN
• Savanah Scarberry, M.S. OTR/L
• SCPG Arkansas LLC (Express Rx of Paris)
• Short Mountain Lodge CSSP LLC
• Kerry Shumate
• Eric James Siebenmorgen, RDN
• Sarah Siebenmorgen, DPT
• Thomas Matthews Spivey, D.D.S.
• Anita Spradling, QBHP

• Adult Care Home Facility in Paris, AR
• Providers in Paris, AR by specialty
• Adult Care Home Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; 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.