St. Bernards Village, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AR354 Issued in AR

Legal business name

ST. BERNARDS VILLAGE, INC.

Practice address

1606 Heern Dr
Jonesboro, AR 72401-5098

Phone

(870) 972-4166

Fax

(870) 972-1749

NPI assigned

Jul 21, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Johnny Kevin Hodges, MBA

Title

V.P. - Senior Services

Phone

(870) 932-8141

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217203200000",
    "number": "1346260270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 HEERN DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015098",
            "telephone_number": "870-972-4166",
            "fax_number": "870-972-1749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 HEERN DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015098",
            "telephone_number": "870-972-4166",
            "fax_number": "870-972-1749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. BERNARDS VILLAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-07-28",
        "status": "A",
        "authorized_official_last_name": "HODGES",
        "authorized_official_first_name": "JOHNNY",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "V.P. - SENIOR SERVICES",
        "authorized_official_telephone_number": "870-932-8141",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AR",
            "license": "AR354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134880732",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St. Bernards Hospital Inc
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• St. Bernards Orthopedic Associates, Inc.
• St. Bernards Urology Associates, Inc.
• John T St. Clair Jr.
• Angela St. Pierre, LCSW
• Jackson Lee St. Pierre, DO
• St.Bernards Imaging Center
• St.Bernards Pet Center LLC

• Assisted Living Facility in Jonesboro, AR
• Providers in Jonesboro, 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 Jul 28, 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.