KMJ Enterprises Benton II, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

711 Issued in AR

Legal business name

KMJ ENTERPRISES BENTON II, LLC

Practice address

6907 Highway 5 N
Bryant, AR 72022-7902

Phone

(501) 213-0547

Fax

(501) 213-0553

NPI assigned

Dec 31, 2013

Organization subpart

No

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

Authorized official

Name

Don Schaap

Title

Ceo

Phone

(479) 636-5716

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Stagecoach Nursing & Rehabilitation Center Doing business as

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

{
    "created_epoch": "1388448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424649600000",
    "number": "1124449632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6907 HIGHWAY 5 N",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "720227902",
            "telephone_number": "501-213-0547",
            "fax_number": "501-213-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6907 HIGHWAY 5 N",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "720227902",
            "telephone_number": "501-213-0547",
            "fax_number": "501-213-0553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KMJ ENTERPRISES BENTON II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-31",
        "last_updated": "2015-02-23",
        "status": "A",
        "authorized_official_last_name": "SCHAAP",
        "authorized_official_first_name": "DON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "479-636-5716"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200762311",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stagecoach Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristin Kiernan
• Camille Jane King
• Kreshun Tyrus King Sr.
• Nicki Shauntel Kinley, LCSW
• Kirby J. Robinson, DDS of Arkansas, PLLC
• Tanner Allen Koch, LAT/ATC
• Kristin N Kiernan Aprn PLLC
• Christina Kulchinski
• Erica Labuda
• Elayna Danielle Antonia Lambert

• Skilled Nursing Facility in Bryant, AR
• Providers in Bryant, 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 Feb 23, 2015; 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.