Organization Active NPI

Area Agency on Aging of Northwest Arkansas

  • Home Health Aide
  • Harrison, AR
National Provider Identifier
1114980109
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Legal business name
AREA AGENCY ON AGING OF NORTHWEST ARKANSAS
Practice address
1510 Rock Springs Rd
Harrison, AR 72601-8804
Phone
(870) 741-1144
Fax
(870) 741-1153
NPI assigned
Apr 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Authorized official

Name
Mr. Richard B Bailey
Title
Executive Director
Phone
(870) 741-1144

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X
Adult Day Care Clinic/Center 261QA0600X
Durable Medical Equipment & Medical Supplies 332B00000X MG00523 AR
Home Delivered Meals 332U00000X
Emergency Response System Companies 333300000X
Home Health AideGroup: 193200000X MULTI-SPECIALTY GROUP 374U00000X Primary

Addresses

Primary practice location

1510 Rock Springs Rd
Harrison, AR 72601-8804

Mailing address

PO Box 1795
Harrison, AR 72602-1795
Phone (870) 741-1144

Other identifiers 7

IdentifierTypeStateIssuer
120518757MedicaidAR
130240754MedicaidAR
120610765MedicaidAR
201547755MedicaidAR
101297732MedicaidAR
164273797MedicaidAR
201546753MedicaidAR

National Provider Directory

National Provider Directory

Locations

1510 Rock Springs Rd
Harrison, AR 72601
Phone (870) 446-2757

1516 Rock Springs Rd
Ste A
Harrison, AR 72601
Phone (870) 741-1505

1508 Rock Springs Rd
Ofc
Harrison, AR 72601
Phone (870) 743-1623

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1114980109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1795",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726021795",
            "telephone_number": "870-741-1144",
            "fax_number": "870-741-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 ROCK SPRINGS RD",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726018804",
            "telephone_number": "870-741-1144",
            "fax_number": "870-741-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AREA AGENCY ON AGING OF NORTHWEST ARKANSAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "870-741-1144",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AR",
            "license": "MG00523",
            "primary": false
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333300000X",
            "taxonomy_group": "",
            "desc": "Emergency Response System Companies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120518757",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130240754",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120610765",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201547755",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101297732",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164273797",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201546753",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrison, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.