Organization Active NPI

Leo N Levi Memorial Hospital Association

  • General Acute Care Hospital
  • Hot Springs, AR
National Provider Identifier
1124021811
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
2393 Issued in AR
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

Updated by the provider on Dec 12, 2024

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
11511OtherARBCBS- HOSPICE
10132OtherARBCBS PROV#
140836726MedicaidAR
102366105MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
CorporationNon-profit
Incorporated
Sep 7, 1910 in AR
Enrollment address
300 Prospect Ave
Levi Hospital
Hot Springs, AR 71901-4003
Hospital Psychiatric Unit
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.

National Provider Directory

National Provider Directory

Ownership & 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.

NameRoleSinceShare
Courtney Crouch Individual Corporate Director Mar 31, 2015
Robert Aspell Individual Corporate Director Dec 16, 2013
Philip Clay Individual Corporate DirectorBoard Member Nov 1, 2007
Leslie Ballentine Individual Corporate Director Jun 23, 2015
Holly Hennessee Individual W-2 Managing EmployeeBusiness Office Director Jan 21, 2019
Ray Owen Individual Corporate DirectorBoard Member Nov 1, 2007
Jim Randall Individual Corporate DirectorBoard Member Nov 1, 2007
Patrick McCabe Individual Corporate OfficerPresident and Ceo Nov 1, 2007
W-2 Managing EmployeePresident and Ceo Nov 1, 2007
Karen Reagler Individual Corporate DirectorBoard Member Nov 1, 2007
Harold Koppel Individual Corporate DirectorBoard Member Nov 1, 2007
Dennis Smith Individual Corporate DirectorBoard Member Nov 1, 2007
Cari L Cordell Individual Corporate Director Apr 18, 2017
Brad Wolken Individual Corporate Director Dec 16, 2013
Stuart a Fleischner Individual Corporate DirectorBoard Member 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.

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

Verify at the official NPI Registry.