Active NPI
Bear Creek Healthcare, LLC
- Skilled Nursing Facility
- De Queen, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 1054
- Legal business name
- BEAR CREEK HEALTHCARE, LLC
- Practice address
- 322 W Collin Raye Dr
De Queen, AR 71832-2007 - Phone
- (870) 642-3562
- Fax
- (870) 642-8226
- NPI assigned
- Dec 16, 2016
- Last updated
- Jun 20, 2018
- 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
- Mrs. Cathy Lynn Parsons
- Title
- Owner
- Phone
- (501) 499-6651
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 1054 | AR | Primary |
Addresses
Primary practice location
322 W Collin Raye Dr
De Queen, AR 71832-2007
Mailing address
PO Box 1369
Conway, AR 72033-1369
Phone (501) 049-9665
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170504001194 | AR | Part A Provider - Skilled Nursing Facility | 7012294838 | Practice locations: De Queen, AR |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1154865616. Details of each certification follow.
Skilled nursing facility certification: CCN 045287
- Legal name
- BEAR CREEK HEALTHCARE, LLC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 1, 1995
- Last certification
- Oct 17, 2024
- Beds
- 131
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC
- Enrollment address
- 322 W Collin Raye Dr
De Queen, AR 71832-2007 - Nursing home name
- BEAR CREEK HEALTHCARE LLC
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Bear Creek Healthcare LLC
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jun 1, 1995
- Medicare certification status
- Active
- Certified beds
- 131
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D0688970 | Bear Creek Healthcare | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryLocations
322 W Collin Raye Dr
De Queen, AR 71832
Phone (870) 642-3562
Ownership & related parties
All disclosed owners & managing parties 1
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 |
|---|---|---|---|
| Cathy L Parsons | 5% Or Greater Direct Ownership Interest | Jan 1, 2017 | 100% |
| W-2 Managing Employee | Jan 1, 2017 |
Practitioners & affiliated clinicians
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481846400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1529452800000",
"number": "1154865616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1369",
"city": "CONWAY",
"state": "AR",
"postal_code": "720331369",
"telephone_number": "501-049-9665",
"fax_number": "501-224-4598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "322 W COLLIN RAYE DR",
"city": "DE QUEEN",
"state": "AR",
"postal_code": "718322007",
"telephone_number": "870-642-3562",
"fax_number": "870-642-8226"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BEAR CREEK HEALTHCARE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-12-16",
"last_updated": "2018-06-20",
"status": "A",
"authorized_official_last_name": "PARSONS",
"authorized_official_first_name": "CATHY",
"authorized_official_middle_name": "LYNN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "501-499-6651",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "AR",
"license": "1054",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in De Queen, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.