NPIMap

Organization Active NPI

Johnson Regional Medical Center

  • Home Health Agency
  • Clarksville, AR
National Provider Identifier
1255380416
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
JOHNSON REGIONAL MEDICAL CENTER
Doing business as
JRMC Home Health Care
Practice address
1100 E Poplar St
Clarksville, AR 72830-4419
Phone
(479) 754-5454
Fax
(479) 754-5311
NPI assigned
May 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Robert Larry Morse
Title
Administrator
Phone
(479) 754-5454

Specialties & licenses 1

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

Addresses

Primary practice location

1100 E Poplar St
Clarksville, AR 72830-4419

Mailing address

PO Box 738
Clarksville, AR 72830-0738
Phone (479) 754-5454

Other identifiers 1

IdentifierTypeStateIssuer
17153OtherARHOME HEALTH AGENCY

Other names 1

  • JRMC Home Health Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080725000569 AR Part A Provider - Home Health Agency 1658360284 Practice locations: Clarksville, AR

Home health agency certification: CCN 047153

Legal name
JOHNSON REGIONAL MEDICAL CENTER
Doing business as
JOHNSON REGIONAL HOME CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 21, 1994
Last certification
Apr 10, 2018
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1996 in AR
Enrollment address
1100 E Poplar St
Johnson Regional Home Care
Clarksville, AR 72830-4419

Other NPIs with the same Medicare PAC ID 9

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Johnson Regional HomecareCCN 047153 · All quality measures
Overall star rating
3 of 5
Ownership
Non-Profit
Certified
Jan 21, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Johnson Regional Med Ctr10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

1100 E Poplar St
Clarksville, AR 72830
Phone (479) 754-5393

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Nancy Hill Individual W-2 Managing EmployeeChief Nursing Officer Jan 1, 2016
Rickey Casey Individual Corporate DirectorBoard Chairman Jan 7, 2019
Whitney Stepp Individual W-2 Managing EmployeeChief Financial Officer Apr 2, 2020
Tommy W Hobbs Individual W-2 Managing Employee Sep 1, 2022

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Johnson Regional Medical CenterClarksville, AR, CCN 040002 Hospital Operational/Managerial Control Jan 4, 2012
JRMC Senior Care UnitClarksville, AR, CCN 04S002 Hospital 5% Or Greater Direct Ownership Interest Jun 4, 2002

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255380416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 738",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728300738",
            "telephone_number": "479-754-5454",
            "fax_number": "479-754-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E POPLAR ST",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728304419",
            "telephone_number": "479-754-5454",
            "fax_number": "479-754-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORSE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LARRY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "479-754-5454",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME HEALTH AGENCY",
            "identifier": "17153",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JRMC Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarksville, AR

Sources for this page

Verify at the official NPI Registry.