Organization Active NPI

Wonder Boys Properties of Arkansas, LLC

  • Skilled Nursing Facility
  • Van Buren, AR
National Provider Identifier
1295914802
Registry record updated Oct 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
845 Issued in AR
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

Updated by the provider on Oct 11, 2013

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
165666311MedicaidAR

Other names 1

  • Van Buren Healthcare and Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
LLCProprietary
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 CenterCCN 045268
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Feb 1, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
140122.3 residents per day on average
Chain
Stein LTC4 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D0900668Van Buren Healthcare & Rehabilitation1404 North 28TH Street, Van Buren, AR 72956Certificate of waiverMay 2, 2027

National Provider Directory

National Provider Directory
Tax ID family
Brownwood Manor Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

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.

NameRoleSinceShare
Nathan Rodriguez Individual Operational/Managerial Control Jul 25, 2022
Adp of the SNF Jul 25, 2022
Paul M Stein Individual 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 Individual 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 Individual Operational/Managerial Control Jan 4, 2008
Adp of the SNF Jan 4, 2008
Robert V Rye Liv TR DTD 10042022 Organization, Fort Smith, AR 5% Or Greater Direct Ownership Interest Jan 16, 2023 40%
Adp of the SNF Oct 13, 2007
Robert a Rye Individual 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.

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

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

Verify at the official NPI Registry.