NPIMap

Organization Active NPI

WCNC, Inc.

  • Skilled Nursing Facility
  • Fayetteville, AR
National Provider Identifier
1194044941
Registry record updated Nov 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
923 Issued in AR
Legal business name
WCNC, INC.
Practice address
4405 Persimmon Street
Fayetteville, AR 72704
Phone
(479) 444-6108
Fax
(479) 444-1403
NPI assigned
May 19, 2010
Organization subpart
Yes
Parent organization
RHC OPERATIONS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 10, 2014

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

Authorized official

Name
Brandon Adams
Title
President
Phone
(501) 932-0050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 923 AR Primary

Addresses

Primary practice location

4405 Persimmon Street
Fayetteville, AR 72704

Mailing address

824 Salem Rd Ste 210
Conway, AR 72034-4855
Phone (501) 932-0050

Other identifiers 1

IdentifierTypeStateIssuer
182798311MedicaidAR

Other names 1

  • Katherine's Place at Wedington Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101018001254 AR Part A Provider - Skilled Nursing Facility 2163615576 Practice locations: Fayetteville, AR

Skilled nursing facility certification: CCN 045434

Legal name
WCNC, INC.
Doing business as
KATHERINE'S PLACE AT WEDINGTON
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 19, 2010
Last certification
May 16, 2024
Beds
119
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Reliance Health
Organization structure
CorporationProprietary
Incorporated
Oct 16, 2008 in AR
Enrollment address
4405 West Persimmon Street
Fayetteville, AR 72704-7512
Nursing home name
KATHERINE'S PLACE AT WEDINGTON
Affiliated entity
ANTHONY & BRYAN ADAMS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Katherine's Place at WedingtonCCN 045434
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Aug 19, 2010
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
119103.6 residents per day on average
Chain
Anthony & Bryan Adams38 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2011152Katherine'S Place at Wedington4405 W Persimmon St, Fayetteville, AR 72704Certificate of waiverAug 11, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Bryan Milburn Adams Individual 5% Or Greater Indirect Ownership InterestVice-President Oct 16, 2008 50%
Corporate OfficerVice President Oct 16, 2008 50%
Adp of the SNF Oct 16, 2008
LTC Systems/RX, LLC Organization, Conway, AR LLC, Consulting firm, For-profit Adp of the SNF Aug 1, 2010
Larry M McGinnis Individual Adp of the SNF Oct 16, 2008
Pharmacy Consults, LLC Organization, Searcy, AR LLC, Consulting firm, For-profit Adp of the SNF Aug 1, 2010
Tammy Angel Individual Managing Control - Governing BodyClinical Nurse Consultant Oct 16, 2008
Adp of the SNF Oct 16, 2008
RHC Real Estate, LLC Organization, Conway, AR LLC, For-profit Adp of the SNF Aug 1, 2010
RHC Operations Inc Organization, Conway, AR Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Oct 16, 2008 100%
Centennial Bank Organization, Conway, AR Corporation, Financial institution, For-profit, Owned by another organization or individual 5% Or Greater Mortgage Interest Apr 1, 2025 23.75%
Adp of the SNF Apr 1, 2025
Kelly Ann Souza Individual Operational/Managerial Control Aug 2, 2022
Managing Control - Governing BodyAdministrator Aug 8, 2022
Adp of the SNF Aug 8, 2022
John Ellis Individual Adp of the SNF Oct 16, 2008
Reliance Health Care, Inc. Organization, Conway, AR Corporation, For-profit Operational/Managerial Control Aug 1, 2010
Adp of the SNF Apr 2, 2025
3B Holdings, LLC Organization, Conway, AR LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2025 76.25%
Adp of the SNF Apr 1, 2025
Tobey Koehler Individual Adp of the SNF Oct 16, 2008
Anthony Brandon Adams Individual 5% Or Greater Indirect Ownership InterestPresident Oct 16, 2008 50%
Corporate OfficerPresident Oct 16, 2008 50%
Adp of the SNF Oct 16, 2008
Indirect Ownership Interest Oct 16, 2008 50%
Darryl Thomas Individual Managing Control - Governing BodyGov Body Member/Dir Fac Ops Oct 16, 2008
Adp of the SNF Oct 16, 2008
Home Bancshares Organization, Conway, AR Financial institution, For-profit, Owned by another organization or individual 5% Or Greater Mortgage Interest Apr 1, 2025 23.75%
Adp of the SNF Apr 1, 2025

Facilities with the same owner 19

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 19

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415577600000",
    "number": "1194044941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 SALEM RD STE 210",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344855",
            "telephone_number": "501-932-0050",
            "fax_number": "501-932-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 PERSIMMON STREET",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72704",
            "telephone_number": "479-444-6108",
            "fax_number": "479-444-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WCNC, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RHC OPERATIONS, INC.",
        "enumeration_date": "2010-05-19",
        "last_updated": "2014-11-10",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-932-0050"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182798311",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Katherine's Place at Wedington",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.