Star City Nursing Center, PLLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0704 Issued in AR

Legal business name

STAR CITY NURSING CENTER, PLLC

Practice address

505 E Victory St
Star City, AR 71667-5327

Phone

(870) 628-4295

Fax

(870) 628-5316

NPI assigned

Aug 2, 2006

Organization subpart

No

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

Authorized official

Name

Keith Head

Title

MBR/Partner

Phone

(870) 628-4295

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1184631202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 E VICTORY ST",
            "city": "STAR CITY",
            "state": "AR",
            "postal_code": "716675327",
            "telephone_number": "870-628-4295",
            "fax_number": "870-628-5316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E VICTORY ST",
            "city": "STAR CITY",
            "state": "AR",
            "postal_code": "716675327",
            "telephone_number": "870-628-4295",
            "fax_number": "870-628-5316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR CITY NURSING CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "HEAD",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "MBR/PARTNER",
        "authorized_official_telephone_number": "870-628-4295"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "0704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC. #",
            "identifier": "0704",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157584311",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holley Shelton, APN-NP
• Cynthia G Slaughter, LCSW
• Misty Brooke Smith, M.S. CF-SLP
• Southeast Arkansas Behavioral Healthcare System
• Southern Caregivers of Star City
• Star City School District
• Star City SNF Operations, LLC
• Starco Ops, LLC
• State of Arkansas
• Frances P Summerford

• Skilled Nursing Facility in Star City, AR
• Providers in Star City, 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 Apr 22, 2008; 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.