NPIMap

Organization Active NPI

Wynne Healthcare Center, LLC

  • Skilled Nursing Facility
  • Wynne, AR
National Provider Identifier
1225048390
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WYNNE HEALTHCARE CENTER, LLC
Practice address
1100 East Martin Dr
Wynne, AR 72396
Phone
(870) 238-4400
Fax
(870) 238-9425
NPI assigned
Aug 9, 2006
Last updated
Apr 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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

Authorized official

Name
Ms. Jeanne Butterworth
Title
Cfo
Phone
(410) 527-4083

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1100 East Martin Dr
Wynne, AR 72396

Mailing address

11350 McCormick Rd
Suite 503
Hunt Valley, MD 21031
Phone (410) 527-4083

Other identifiers 1

IdentifierTypeStateIssuer
155257311MedicaidAR

National Provider Directory

National Provider Directory

Locations

11350 McCormick Rd
Ste 503
Hunt Valley, MD 21031
Phone (410) 771-6868

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1225048390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 MCCORMICK RD",
            "address_2": "SUITE 503",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "21031",
            "telephone_number": "410-527-4083",
            "fax_number": "410-527-4081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 EAST MARTIN DR",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "72396",
            "telephone_number": "870-238-4400",
            "fax_number": "870-238-9425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYNNE HEALTHCARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "BUTTERWORTH",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "410-527-4083",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155257311",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynne, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.