Genesis

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

OTR1586 Issued in AR

Legal business name

GENESIS

Practice address

1513 S Dixieland Rd
Rogers, AR 72758-4935

Phone

(479) 636-5841

NPI assigned

Oct 23, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Michael David, PTA

Title

Physical Therapy Assistant

Phone

(479) 330-0187

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian Charles Green, OT

  • Occupational Therapist
  • Rogers, AR
  • NPI 1780938837
  NPD (past)

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

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350950400000",
    "number": "1386997781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4106 CANDLEWOOD PL",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588253",
            "telephone_number": "479-263-1268"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-23",
        "last_updated": "2012-10-23",
        "status": "A",
        "authorized_official_last_name": "DAVID",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PHYSICAL THERAPY ASSISTANT",
        "authorized_official_telephone_number": "479-330-0187",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "OTR1586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Staci Herndon Gathright, FNP
• Vijay Bhaskar Reddy Gayam, M.D.
• Christa Geduldig, PHARM D
• Scott Geduldig, R.PH.
• Generations Home Care, LLC
• Genesis Partners LLC
• Genesiscare Landmark Arkansas Cancer Care PA
• Genesiscare Landmark Arkansas Cancer Care PA
• Jenny Lynn Gentz, M.S. CCC-SLP
• Carly George

• 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 Oct 23, 2012; 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.