Brookside Health Services

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

BROOKSIDE HEALTH SERVICES

Practice address

800 Brookside Dr
Little Rock, AR 72205-1644

Phone

(501) 224-3940

Fax

(501) 224-6649

NPI assigned

Oct 21, 2008

Last updated

Mar 29, 2011By 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

Joey Martin Wiggins

Title

President

Phone

(501) 305-3153

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301356800000",
    "number": "1174775316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2908 HAWKINS DR",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721434802",
            "telephone_number": "501-305-3153",
            "fax_number": "501-279-3695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BROOKSIDE DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722051644",
            "telephone_number": "501-224-3940",
            "fax_number": "501-224-6649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSIDE HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2011-03-29",
        "status": "A",
        "authorized_official_last_name": "WIGGINS",
        "authorized_official_first_name": "JOEY",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-305-3153"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174614311",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gloria Jean Brooks
• Julia Brooks, RD
• Kathryn Brooks, LPC
• Kimbra Michelle Brooks, MS, RD, LD, CDE
• Brookside Drive Operating LLC (The Blossoms at Breckenridge Rehab & Nursing Center)
• Brookside Healthcare & Rehab, LLC (Brookside Health and Rehabilitation Center)
• Lee Ann Brosh, M.A, CCC-SLP
• Amber Brossett, LCSW
• Erin Broughton, QBHP
• Gwendolyn Broughton

• Skilled Nursing Facility in Little Rock, AR
• Providers in Little Rock, 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 Mar 29, 2011; 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.