Active NPI
Leo N Levi Memorial Hospital Association
- General Acute Care Hospital
- Hot Springs, AR
National Provider Identifier
1124021811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Acute Care Hospital
- License
- 2393
- Legal business name
- LEO N LEVI MEMORIAL HOSPITAL ASSOCIATION
- Practice address
- 300 Prospect Ave
Hot Springs, AR 71901-4003 - Phone
- (501) 624-1281
- Fax
- (501) 622-3343
- NPI assigned
- May 27, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Zane Jeffers
- Title
- President and Ceo
- Phone
- (501) 624-1281
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 2393 | AR | Primary |
Addresses
Primary practice location
300 Prospect Ave
Hot Springs, AR 71901-4003
Mailing address
300 Prospect Ave
Hot Springs, AR 71901-4003
Phone (501) 624-1281
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11511 | Other | AR | BCBS- HOSPICE |
| 10132 | Other | AR | BCBS PROV# |
| 140836726 | Medicaid | AR | |
| 102366105 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071203000756 | AR | Part A Provider - Hospital | 5991752891 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Hot Springs, AR |
Hospital certification: CCN 04S132
- Legal name
- LEO N LEVI MEMORIAL HOSPITAL ASSOCIATION
- Doing business as
- LEVI HOSPITAL
- Organization structure
- Corporation
- Incorporated
- Sep 7, 1910 in AR
- Enrollment address
- 300 Prospect Ave
Levi Hospital
Hot Springs, AR 71901-4003 - Hospital subgroups
- Psychiatric unit
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Psychiatric Hospital Unit
- Hot Springs, AR
- NPI 1639346687
O20071203000756
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 14
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Courtney Crouch | Corporate Director | Mar 31, 2015 | |
| Robert Aspell | Corporate Director | Dec 16, 2013 | |
| Philip Clay | Corporate Director | Nov 1, 2007 | |
| Leslie Ballentine | Corporate Director | Jun 23, 2015 | |
| Holly Hennessee | W-2 Managing Employee | Jan 21, 2019 | |
| Ray Owen | Corporate Director | Nov 1, 2007 | |
| Jim Randall | Corporate Director | Nov 1, 2007 | |
| Patrick McCabe | Corporate Officer | Nov 1, 2007 | |
| W-2 Managing Employee | Nov 1, 2007 | ||
| Karen Reagler | Corporate Director | Nov 1, 2007 | |
| Harold Koppel | Corporate Director | Nov 1, 2007 | |
| Dennis Smith | Corporate Director | Nov 1, 2007 | |
| Cari L Cordell | Corporate Director | Apr 18, 2017 | |
| Brad Wolken | Corporate Director | Dec 16, 2013 | |
| Stuart a Fleischner | Corporate Director | Nov 1, 2007 |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- General Practice Dentistry
- Hot Springs, AR
- NPI 1225137318
Corporate Director
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117152000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1733961600000",
"number": "1124021811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 PROSPECT AVE",
"city": "HOT SPRINGS",
"state": "AR",
"postal_code": "719014003",
"telephone_number": "501-624-1281",
"fax_number": "501-622-3343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 PROSPECT AVE",
"city": "HOT SPRINGS",
"state": "AR",
"postal_code": "719014003",
"telephone_number": "501-624-1281",
"fax_number": "501-622-3343"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LEO N LEVI MEMORIAL HOSPITAL ASSOCIATION",
"organizational_subpart": "NO",
"enumeration_date": "2005-05-27",
"last_updated": "2024-12-12",
"certification_date": "2024-12-12",
"status": "A",
"authorized_official_last_name": "JEFFERS",
"authorized_official_first_name": "ZANE",
"authorized_official_title_or_position": "PRESIDENT AND CEO",
"authorized_official_telephone_number": "501-624-1281",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "AR",
"license": "2393",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS- HOSPICE",
"identifier": "11511",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROV#",
"identifier": "10132",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "140836726",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102366105",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hot Springs, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.