Innisfree Nursing Ctr Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

552 Issued in AR

Legal business name

INNISFREE NURSING CTR INC

Practice address

301 S 24TH St
Rogers, AR 72758-1116

Phone

(479) 636-5545

Fax

(479) 636-9095

NPI assigned

Sep 22, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Charles John Rusgis Jr.

Title

Owner

Phone

(479) 636-5545

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255327508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S 24TH ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581116",
            "telephone_number": "479-636-5545",
            "fax_number": "479-636-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S 24TH ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581116",
            "telephone_number": "479-636-5545",
            "fax_number": "479-636-9095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNISFREE NURSING CTR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUSGIS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-636-5545",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AR",
            "license": "552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "15302",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Rogers, AR
• Providers in Rogers, 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.