NPIMap

Organization Active NPI

Fcnrc, Inc.

  • Skilled Nursing Facility
  • Salem, AR
National Provider Identifier
1376531202
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
760 Issued in AR
Legal business name
FCNRC, INC.
Practice address
624 Hwy 62/412 West
Salem, AR 72576
Phone
(870) 895-3817
Fax
(870) 368-4054
NPI assigned
Oct 13, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2013

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

Authorized official

Name
Johniece Taylor
Title
Sec
Phone
(870) 368-4054

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 760 AR Primary

Addresses

Primary practice location

624 Hwy 62/412 West
Salem, AR 72576

Mailing address

PO Box 918
Melbourne, AR 72556-0918
Phone (870) 895-3817

Other identifiers 1

IdentifierTypeStateIssuer
154017311MedicaidAR

Other names 1

  • Southfork River Therapy & Living Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380067200000",
    "number": "1376531202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 918",
            "city": "MELBOURNE",
            "state": "AR",
            "postal_code": "725560918",
            "telephone_number": "870-895-3817",
            "fax_number": "870-368-4054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 HWY 62/412 WEST",
            "city": "SALEM",
            "state": "AR",
            "postal_code": "72576",
            "telephone_number": "870-895-3817",
            "fax_number": "870-368-4054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FCNRC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-13",
        "last_updated": "2013-09-25",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "JOHNIECE",
        "authorized_official_title_or_position": "SEC",
        "authorized_official_telephone_number": "870-368-4054"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154017311",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southfork River Therapy & Living Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; 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.