NPIMap

Organization Active NPI

Medi-Home, Inc

  • Skilled Nursing Facility
  • Fort Smith, AR
National Provider Identifier
1376562660
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
045 Issued in AR
Legal business name
MEDI-HOME, INC
Practice address
4623 Rogers Ave
Fort Smith, AR 72903-4623
Phone
(479) 452-1541
Fax
(479) 452-2589
NPI assigned
Jul 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Imeldia Sue Rusher, LPN ADM
Title
Administrator
Phone
(479) 452-1541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 045 AR Primary

Addresses

Primary practice location

4623 Rogers Ave
Fort Smith, AR 72903-4623

Mailing address

4623 Rogers Ave
Fort Smith, AR 72903-4623
Phone (479) 452-1541

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376562660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4623 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034623",
            "telephone_number": "479-452-1541",
            "fax_number": "479-452-2589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4623 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034623",
            "telephone_number": "479-452-1541",
            "fax_number": "479-452-2589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDI-HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUSHER",
        "authorized_official_first_name": "IMELDIA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "479-452-1541",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPN ADM"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.