SRN Management, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1059 Issued in AR

Legal business name

SRN MANAGEMENT, LLC

Doing business as

Cottage Lane Health and Rehab

Practice address

800 Brookside Dr
Little Rock, AR 72205-1644

Phone

(501) 224-3940

Fax

(501) 224-6649

NPI assigned

Jun 5, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Robert Andrew Rye

Title

Vice President

Phone

(479) 410-1740

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cottage Lane Health and Rehab Doing business as

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

{
    "created_epoch": "1433462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476748800000",
    "number": "1174903025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8520 S 36TH TER",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729088880",
            "telephone_number": "479-410-1740",
            "fax_number": "479-410-1596"
        },
        {
            "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": "SRN MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-05",
        "last_updated": "2016-10-18",
        "status": "A",
        "authorized_official_last_name": "RYE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "479-410-1740",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "1059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208289311",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cottage Lane Health and Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 Oct 18, 2016; 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.