NPIMap

Organization Active NPI

State of Arkansas

Doing business as Boone County Health Unit

  • Home Health Agency
  • Harrison, AR
National Provider Identifier
1235150087
Registry record updated Aug 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
AR3974 Issued in AR
Legal business name
STATE OF ARKANSAS
Doing business as
Boone County Health Unit
Practice address
1622 Campus Ave
Boone County Health Unit
Harrison, AR 72601-5524
Phone
(870) 743-5244
Fax
(870) 741-1351
NPI assigned
Jul 21, 2006
Last updated
Aug 5, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
STATE OF ARKANSASAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 5, 2008

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

Authorized official

Name
Marilyn Evans, RN
Title
Home Health Administrator
Phone
(501) 661-2540

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X AR3974 AR Primary

Addresses

Primary practice location

1622 Campus Ave
Boone County Health Unit
Harrison, AR 72601-5524

Mailing address

5800 West 10TH Street
Suite 300
Little Rock, AR 72204-1764
Phone (501) 661-2614

Other identifiers 1

IdentifierTypeStateIssuer
104312514MedicaidAR

Other names 1

  • Boone County Health Unit Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Tax ID family
Centerwell Home Health14 organizations share this tax ID, including this one
Part of
State of Arkansas

Other organizations with this tax ID 13

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

View all 13

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1622 Campus Ave
Harrison, AR 72601
Phone (870) 743-5244

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Aug 1, 2016 Change of OwnershipThis provider was the seller Centerwell Home HealthCCN 047803, AR, NPI 1003266024

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217894400000",
    "number": "1235150087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 WEST 10TH STREET",
            "address_2": "SUITE 300",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041764",
            "telephone_number": "501-661-2614",
            "fax_number": "501-661-2975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 CAMPUS AVE",
            "address_2": "BOONE COUNTY HEALTH UNIT",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726015524",
            "telephone_number": "870-743-5244",
            "fax_number": "870-741-1351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF ARKANSAS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF ARKANSAS",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-08-05",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "HOME HEALTH ADMINISTRATOR",
        "authorized_official_telephone_number": "501-661-2540",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AR",
            "license": "AR3974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104312514",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boone County Health Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrison, AR

Sources for this page

Verify at the official NPI Registry.