Area Agency on Aging of Western Arkansas, Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

0161 Issued in AR

Legal business name

AREA AGENCY ON AGING OF WESTERN ARKANSAS, INC

Practice address

550 Heritage Dr
Booneville, AR 72927-3862

Phone

(479) 675-4234

NPI assigned

May 1, 2006

Last updated

Oct 3, 2007By 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

Lisa Rushing

Title

Supervisor of Corporate Services

Phone

(479) 783-4500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1144287202. Details of each certification follow.

• CCN 041509 Hospice · Active · Details

Hospice certification: CCN 041509

Legal name

AREA AGENCY ON AGING OF WESTERN ARKANSAS, INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Nov 23, 1988

Last certification

Oct 23, 2019

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationNon-profit

Incorporated

Jun 21, 1979 in AR

Enrollment address

333 S 1St St
Paris, AR 72855-4453

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Area Agency on Aging of Western Arkansas, Inc

  • Community Based Hospice Care Agency
  • Ozark, AR
  • NPI 1093772741

  O20070201000022

  Same enrollment
• Area Agency on Aging of Western Arkansas, Inc

  dba Visiting Nurses Agency of Western Arkansas, Inc.

  • Community Based Hospice Care Agency
  • Clarksville, AR
  • NPI 1437116621

  O20070201000022

  Same enrollment
• Area Agency on Aging of Western Arkansas, Inc

  • Community Based Hospice Care Agency
  • Paris, AR
  • NPI 1891752556

  O20070201000022

  Same enrollment

Listed as

Area Agency on Aging of Western Arkansas, Inc.CCN 041509 · All quality measures

Ownership

Non-Profit

Certified

Nov 23, 1988

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Philip Dunn Elangwe, M.D.

  • Family Medicine Physician
  • Fort Smith, AR
  • NPI 1780776435

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1144287202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 GARRISON AVE",
            "address_2": "PO BOX 1724",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729012514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 HERITAGE DR",
            "city": "BOONEVILLE",
            "state": "AR",
            "postal_code": "729273862",
            "telephone_number": "479-675-4234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AREA AGENCY ON AGING OF WESTERN ARKANSAS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "RUSHING",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "SUPERVISOR OF CORPORATE SERVICES",
        "authorized_official_telephone_number": "479-783-4500"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "AR",
            "license": "0161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Access Medical Clinic Arkansas LLC (Access Medical Podiatry)
• Access Medical Clinic Arkansas LLC
• Sahibzada A Ahmed, M.D.
• Jackson Brett Allen, PHARMD
• Area Agency on Aging of Western Arkansas, Inc
• Allyson Baker, MS, CF-SLP
• Ariel Beavers, QBHP
• Dennis Jared Berry, MD
• Big World Drug Enterprises Inc

• Community Based Hospice Care Agency in Booneville, AR
• Providers in Booneville, AR by specialty
• Community Based Hospice Care Agency in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.