NPIMap

Organization Active NPI

Crestpark Forrest City, LLC

  • Skilled Nursing Facility
  • Forrest City, AR
National Provider Identifier
1417102468
Registry record updated Nov 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
638 Issued in AR
Legal business name
CRESTPARK FORREST CITY, LLC
Practice address
500 Kittle Rd
Forrest City, AR 72335-2417
Phone
(870) 633-4260
Fax
(870) 633-1486
NPI assigned
Nov 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2008

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

Authorized official

Name
Mrs. Barbara Belew
Title
Manager
Phone
(501) 626-7986

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 638 AR Primary

Addresses

Primary practice location

500 Kittle Rd
Forrest City, AR 72335-2417

Mailing address

PO Box 1658
Forrest City, AR 72336-1658
Phone (870) 633-4260

Other identifiers 2

IdentifierTypeStateIssuer
015219OtherARBCBS PROVIDER NUMBER
PENDINGMedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090925000317 AR Part A Provider - Skilled Nursing Facility 8820144249 Practice locations: Forrest City, AR

Skilled nursing facility certification: CCN 045219

Legal name
CRESTPARK FORREST CITY, LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 1, 1993
Last certification
Aug 8, 2024
Beds
100
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Oct 22, 2008 in AR
Enrollment address
500 Kittle Road
Forrest City, AR 72336-1658
Nursing home name
CRESTPARK FORREST CITY, LLC
Affiliated entity
CRESTPARK

Care Compare: Nursing home

Medicare Care Compare
Listed as
Crestpark Forrest City, LLCCCN 045219
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Nov 1, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10040.4 residents per day on average
Chain
Crestpark6 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Dilks, LLC Organization, Marianna, AR Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Sep 1, 2009 50%
Operational/Managerial Control Sep 1, 2009
Direct Ownership Interest Sep 1, 2009 50%
Individual Adp of the SNF Jul 1, 2022
Indirect Ownership Interest Sep 1, 2009
Individual Adp of the SNF Sep 1, 2009
Indirect Ownership Interest Sep 1, 2009
Barbara Belew Individual 5% Or Greater Indirect Ownership Interest Sep 1, 2009 50%
Operational/Managerial Control Sep 1, 2009
Indirect Ownership Interest Sep 1, 2009 50%
Belew, LLC Organization, Marianna, AR Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Sep 1, 2009 50%
Operational/Managerial Control Sep 1, 2009
Direct Ownership Interest Sep 1, 2009 50%
Melisha Dilks Individual 5% Or Greater Indirect Ownership Interest Sep 1, 2009 50%
Indirect Ownership Interest Sep 1, 2009 50%

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1226966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226966400000",
    "number": "1417102468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1658",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723361658",
            "telephone_number": "870-633-4260",
            "fax_number": "870-633-1486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 KITTLE RD",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723352417",
            "telephone_number": "870-633-4260",
            "fax_number": "870-633-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTPARK FORREST CITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-18",
        "last_updated": "2008-11-18",
        "status": "A",
        "authorized_official_last_name": "BELEW",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "501-626-7986",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "015219",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forrest City, AR

Sources for this page

Verify at the official NPI Registry.