Thrive Pediatric Nursing Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

THRIVE PEDIATRIC NURSING INC

Doing business as

Thrive At Home

Practice address

7197 Sheridan Rd Ste 105
White Hall, AR 71602-3261

Phone

(870) 247-6131

NPI assigned

Jan 4, 2018

Organization subpart

No

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

Authorized official

Name

Michelle M Mantuano

Title

President

Phone

(870) 247-6131

Specialties & licenses 3

Addresses

Other identifiers 5

Other names 1

• Thrive At Home Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Home health agency certification: CCN 047180

Legal name

THRIVE PEDIATRIC NURSING INC

Doing business as

THRIVE AT HOME

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Apr 8, 2019

Last certification

Dec 7, 2018

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Oct 6, 2015 in AR

Enrollment address

7197 Sheridan Rd
Ste 105
White Hall, AR 71602-3261

Listed as

Thrive at HomeCCN 047180

Ownership

Proprietary

Certified

Apr 8, 2019

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Physical therapy, Speech pathology, Occupational therapy

Tax ID family

Thrive at Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Thrive Pediatric Nursing Inc

  • Nursing Care Agency
  • White Hall, AR
  • NPI 1063195808
  NPD tax ID

Locations

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.

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692576000000",
    "number": "1174030860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7197 SHERIDAN RD STE 105",
            "city": "WHITE HALL",
            "state": "AR",
            "postal_code": "716023261",
            "telephone_number": "870-247-6131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7197 SHERIDAN RD STE 105",
            "city": "WHITE HALL",
            "state": "AR",
            "postal_code": "716023261",
            "telephone_number": "870-247-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIVE PEDIATRIC NURSING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-04",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A",
        "authorized_official_last_name": "MANTUANO",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-247-6131"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": "AR5369",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLASS A AND B DERIVITIVE",
            "identifier": "AR5480",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "224683738",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "235534514",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLASS B (NEW)",
            "identifier": "AR5648",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS HOME HEALTH CLASS B",
            "identifier": "AR5369",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "thriveathomear.com",
            "affiliation": "N",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7197 Sheridan Rd Ste 105",
            "city": "White Hall",
            "state": "AR",
            "country_code": "US",
            "postal_code": "716023261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Thrive At Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Terry L Boone DDS, PA
• The Waters of White Hall, LLC
• Marquetta Thompson, PLMSW
• Nikki Thornton, LCSW
• Thrive Pediatric Nursing Inc
• Tim Wilkin D.O., P.a.
• Joan Traywick, RN
• Trifecta Care
• Triple Threats 333
• Michael C Tucker, DC

• Home Health Agency in White Hall, AR
• Providers in White Hall, AR by specialty
• Home Health Agency in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.