NPIMap

Organization Active NPI

Spring River Home Health Agency Inc

Doing business as Spring River Therapy

  • Physical Therapist
  • Salem, AR
National Provider Identifier
1205476322
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SPRING RIVER HOME HEALTH AGENCY INC
Doing business as
Spring River Therapy
Practice address
1323 Hwy 9 N
Salem, AR 72576
Phone
(870) 895-2627
Fax
(870) 895-4440
NPI assigned
Jan 7, 2020
Last updated
Dec 3, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
SPRING RIVER HOME HEALTH AGENCY INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Authorized official

Name
Kimberley Tyler
Title
Biller
Phone
(870) 895-2627

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X
Physical Therapist 225100000X Primary
Physical Therapy Assistant 225200000X
Occupational Therapist 225X00000X
Speech-Language Pathologist 235Z00000X

Addresses

Primary practice location

1323 Hwy 9 N
Salem, AR 72576

Mailing address

PO Box 755
Salem, AR 72576-0755
Phone (870) 895-2627

Other names 1

  • Spring River Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210120000062 AR Part B Supplier - Clinic/Group Practice 5991967796 Receives reassigned benefits from 5 practitioners
Practice locations: Salem, AR

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Spring River Home Health Agency Inc4 organizations share this tax ID, including this one
Part of
Spring River Home Health Agency Inc

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606953600000",
    "number": "1205476322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 755",
            "city": "SALEM",
            "state": "AR",
            "postal_code": "725760755",
            "telephone_number": "870-895-2627",
            "fax_number": "870-895-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1323 HWY 9 N",
            "city": "SALEM",
            "state": "AR",
            "postal_code": "72576",
            "telephone_number": "870-895-2627",
            "fax_number": "870-895-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRING RIVER HOME HEALTH AGENCY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPRING RIVER HOME HEALTH AGENCY INC",
        "enumeration_date": "2020-01-07",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A",
        "authorized_official_last_name": "TYLER",
        "authorized_official_first_name": "KIMBERLEY",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "870-895-2627"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spring River Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.