KMJ Enterprises Heritage Park LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

714 Issued in AR

Legal business name

KMJ ENTERPRISES HERITAGE PARK LLC

Practice address

1513 S Dixieland Rd
Rogers, AR 72758-4935

Phone

(479) 636-5841

Fax

(479) 621-8345

NPI assigned

Sep 26, 2005

Organization subpart

Yes

Parent organization

KMJ MANAGEMENTAs reported in NPPES

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

Authorized official

Name

Ms. Patricia A Miller

Title

President Ceo

Phone

(479) 636-5716

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Heritage Park Nursing Center Doing business as

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1306832167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 S DIXIELAND RD",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727584935",
            "telephone_number": "479-636-5841",
            "fax_number": "479-621-8345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 S DIXIELAND RD",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727584935",
            "telephone_number": "479-636-5841",
            "fax_number": "479-621-8345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KMJ ENTERPRISES HERITAGE PARK LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KMJ MANAGEMENT",
        "enumeration_date": "2005-09-26",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "479-636-5716",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119722311",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Park Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alma Kivi, M.S. LAC
• Kimberly Ann Klinefelter, FNP-C
• Nicole Klones, PHARMD
• KMJ Billings, LLC
• KMJ Enterprises Gravette LLC
• Jessica Carol Knight, APRN
• Robert Graham Knight
• Kelly Knollmann, CRNA
• Robert Hogan Knox, M.D.
• Miriam Koesy, PMHNP

• Skilled Nursing Facility in Rogers, AR
• Providers in Rogers, AR by specialty
• Skilled Nursing Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; 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.