Village Gardens

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

019 Issued in AR

Legal business name

VILLAGE GARDENS

Practice address

265 Dave Creek Pkwy
Fairfield Bay, AR 72088-3106

Phone

(501) 884-3210

Fax

(501) 884-6800

NPI assigned

Mar 5, 2007

Last updated

Aug 22, 2020By 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

Morris Monroe Beavers, RN

Title

V. P. of Operations

Phone

(501) 680-5591

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215066998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 DAVE CREEK PKWY",
            "city": "FAIRFIELD BAY",
            "state": "AR",
            "postal_code": "720883106",
            "telephone_number": "501-884-3210",
            "fax_number": "501-884-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 DAVE CREEK PKWY",
            "city": "FAIRFIELD BAY",
            "state": "AR",
            "postal_code": "720883106",
            "telephone_number": "501-884-3210",
            "fax_number": "501-884-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE GARDENS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BEAVERS",
        "authorized_official_first_name": "MORRIS",
        "authorized_official_middle_name": "MONROE",
        "authorized_official_title_or_position": "V. P. OF OPERATIONS",
        "authorized_official_telephone_number": "501-680-5591",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AR",
            "license": "019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Indian Rock Healthcare LLC (The Springs of Fairfield Bay)
• Indian Rock Village, LLC
• Jodi Marie Keller
• Samantha Rose O'Neal
• Ozark Health, Inc (Ozark Medical Clinic - Fairfield Bay)
• Stephanie Walters

• Assisted Living Facility in Fairfield Bay, AR
• Providers in Fairfield Bay, AR by specialty
• Assisted Living Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.