Active NPI
Wonder Boys Properties of Arkansas, LLC
- Skilled Nursing Facility
- Van Buren, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 845
- Legal business name
- WONDER BOYS PROPERTIES OF ARKANSAS, LLC
- Practice address
- 1404 N 28TH St
Van Buren, AR 72956-2931 - Phone
- (479) 474-8022
- Fax
- (479) 471-8570
- NPI assigned
- Oct 31, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Robert Andrew Rye
- Title
- President
- Phone
- (479) 410-1740
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 845 | AR | Primary |
Addresses
Primary practice location
1404 N 28TH St
Van Buren, AR 72956-2931
Mailing address
8520 S 36TH Ter
Fort Smith, AR 72908-8880
Phone (479) 410-1740
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 165666311 | Medicaid | AR |
Other names 1
- Van Buren Healthcare and Rehabilitation Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071205000109 | AR | Part A Provider - Skilled Nursing Facility | 7719076314 | Practice locations: Van Buren, AR |
Skilled nursing facility certification: CCN 045268
- Legal name
- WONDER BOYS PROPERTIES OF ARKANSAS, LLC
- Doing business as
- VAN BUREN HEALTHCARE AND REHABILITATION CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Feb 1, 1995
- Last certification
- Sep 19, 2024
- Beds
- 140
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC
- Incorporated
- Sep 6, 2007 in AR
- Enrollment address
- 1404 N 28TH St
Van Buren, AR 72956-2931 - Nursing home name
- VAN BUREN HEALTHCARE AND REHABILITATION CENTER
- Affiliated entity
- STEIN LTC
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Van Buren Healthcare and Rehabilitation Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Feb 1, 1995
- Medicare certification status
- Active
- Certified beds
- 140
- Chain
- Stein LTC
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D0900668 | Van Buren Healthcare & Rehabilitation | Certificate of waiver | May 2, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Brownwood Manor Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Skilled Nursing Facility
- Van Buren, AR
- NPI 1023103918
Locations
1404 N 28th St
Van Buren, AR 72956
Phone (479) 474-8021
Ownership & related parties
All disclosed owners & managing parties 6
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Nathan Rodriguez | Operational/Managerial Control | Jul 25, 2022 | |
| Adp of the SNF | Jul 25, 2022 | ||
| Paul M Stein | 5% Or Greater Direct Ownership Interest | Oct 13, 2007 | 20% |
| Operational/Managerial Control | Oct 13, 2007 | ||
| Adp of the SNF | Oct 13, 2007 | ||
| James M Stein | 5% Or Greater Direct Ownership Interest | Oct 13, 2007 | 20% |
| Operational/Managerial Control | Oct 13, 2007 | ||
| Adp of the SNF | Oct 13, 2007 | ||
| Danny Silver | Operational/Managerial Control | Jan 4, 2008 | |
| Adp of the SNF | Jan 4, 2008 | ||
| Robert V Rye Liv TR DTD 10042022 | 5% Or Greater Direct Ownership Interest | Jan 16, 2023 | 40% |
| Adp of the SNF | Oct 13, 2007 | ||
| Robert a Rye | 5% Or Greater Direct Ownership Interest | Oct 13, 2007 | 20% |
| Operational/Managerial Control | Oct 13, 2007 | ||
| Adp of the SNF | Oct 13, 2007 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Emergency Medicine Physician
- Fort Smith, AR
- NPI 1972582260
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 2
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Prairie Grove, AR
- NPI 1588833974
Robert V Rye Liv TR DTD 10042022
-
- Skilled Nursing Facility
- Rogers, AR
- NPI 1992185789
Robert V Rye Liv TR DTD 10042022
Practitioners & affiliated clinicians
Affiliated clinicians 1
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": "1193788800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1381449600000",
"number": "1295914802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8520 S 36TH TER",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729088880",
"telephone_number": "479-410-1740",
"fax_number": "479-410-1596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1404 N 28TH ST",
"city": "VAN BUREN",
"state": "AR",
"postal_code": "729562931",
"telephone_number": "479-474-8022",
"fax_number": "479-471-8570"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WONDER BOYS PROPERTIES OF ARKANSAS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-31",
"last_updated": "2013-10-11",
"status": "A",
"authorized_official_last_name": "RYE",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "ANDREW",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "479-410-1740",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "AR",
"license": "845",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "165666311",
"state": "AR"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Van Buren Healthcare and Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Van Buren, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.