Area Agency on Aging of Western Arkansas, Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

0173 Issued in AR

Legal business name

AREA AGENCY ON AGING OF WESTERN ARKANSAS, INC

Practice address

1579 Clyde Hawkins Dr
Waldron, AR 72958-8972

Phone

(479) 637-4795

NPI assigned

May 1, 2006

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

Hospice certification: CCN 041515

Legal name

AREA AGENCY ON AGING OF WESTERN ARKANSAS, INC

Doing business as

VISITING NURSES AGENCY OF WESTERN ARKANSAS INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Oct 26, 1989

Last certification

Jul 19, 2019

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationNon-profit

Incorporated

Jun 21, 1979 in AR

Enrollment address

600 7TH St
Mena, AR 71953-3205

Other NPIs on the same Medicare enrollment 2

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
  • Mena, AR
  • NPI 1386601706

  O20070201000017

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

  • Community Based Hospice Care Agency
  • Mt. Ida, AR
  • NPI 1598713604

  O20070201000017

  Same enrollment

Listed as

Visiting Nurses Agency of Western Arkansas IncCCN 041515

Ownership

Non-Profit

Certified

Oct 26, 1989

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.

• David Henderson, M.D.

  • Internal Medicine Physician
  • Mena, AR
  • NPI 1306995527

  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": "1191283200000",
    "number": "1174580252",
    "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": "1579 CLYDE HAWKINS DR",
            "city": "WALDRON",
            "state": "AR",
            "postal_code": "729588972",
            "telephone_number": "479-637-4795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AREA AGENCY ON AGING OF WESTERN ARKANSAS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2007-10-02",
        "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": "0173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Addus Health Care Inc
• Area Agency on Aging of Western Arkansas, Inc
• Janie Nichole Atchley, RN
• Robbins Mark Bailey, D.D.S.
• Sherilyn Jo Bennett, APRN
• Faith Brown

• All providers in Waldron, AR
• 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 2, 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.