NPIMap

Organization Active NPI

Lake Village Operations LLC

  • Skilled Nursing Facility
  • Lake Village, AR
National Provider Identifier
1427894567
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LAKE VILLAGE OPERATIONS LLC
Practice address
903 Borgognoni Dr
Lake Village, AR 71653-1623
Phone
(870) 265-5337
NPI assigned
Jul 8, 2024
Last updated
Mar 11, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Authorized official

Name
John F Ponthie
Title
Member
Phone
(318) 216-3316

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

903 Borgognoni Dr
Lake Village, AR 71653-1623

Mailing address

903 Borgognoni Dr
Lake Village, AR 71653-1623
Phone (870) 265-5337

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240904001411 AR Part A Provider - Skilled Nursing Facility 3870033988 Practice locations: Lake Village, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1427894567. Details of each certification follow.

Skilled nursing facility certification: CCN 045184

Legal name
LAKE VILLAGE OPERATIONS LLC
Doing business as
LAKE VILLAGE REHABILITATION AND CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1992
Last certification
Sep 6, 2024
Beds
82
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Southern Administrative Services
Organization structure
LLCProprietary
Enrollment address
903 Borgognoni Dr
Lake Village, AR 71653-1623
Nursing home name
LAKE VILLAGE REHABILITATION AND CARE CENTER
Affiliated entity
SOUTHERN ADMINISTRATIVE SERVICES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Lake Village Rehabilitation and Care CenterCCN 045184 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 1, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8256.9 residents per day on average
Chain
Southern Administrative Services35 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 24

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

NameRoleSinceShare
Teams Staffing LLC Organization, Alexandria, LA LLC, Medical staffing company Adp of the SNF Dec 16, 2024
Ponthie Management LLC Organization, Alexandria, LA LLC Adp of the SNF Dec 17, 2024
Jej Assets LP Organization, Shreveport, LA Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 1, 2024 100%
Adp of the SNF Dec 16, 2024
Tammy Ann Thompson 2021 Children's Trust Organization, Boyce, LA Adp of the SNF Dec 17, 2024
Procare Therapy Services LLC Organization, Alexandria, LA LLC, Medical provider/supplier Adp of the SNF Dec 16, 2024
Amanda Wallace Individual Operational/Managerial Control Aug 1, 2024
Adp of the SNF Aug 1, 2024
Tammy Thompson Individual Adp of the SNF Dec 6, 2024
Mark Kelly Thmpson 2020 Chikdren's Trust Organization, Boyce, LA Adp of the SNF Dec 17, 2024
Ponthie Investments Limited Partnership Organization, Alexandria, LA Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 1, 2024 40%
Alexark1 LLC Organization, Houston, TX LLC Adp of the SNF Dec 6, 2024
Jej Management, LLC Organization, Shreveport, LA LLC Adp of the SNF Dec 6, 2024
Mark Thompson Family Management LLC Organization, Alexandria, LA LLC Adp of the SNF Dec 17, 2024
John F Ponthie Individual 5% Or Greater Indirect Ownership Interest Aug 1, 2024 20%
Corporate OfficerCeo Aug 1, 2024 100%
LV SNF Assets LLC Organization, Alexandria, LA LLC Adp of the SNF Dec 16, 2024
Mark Thompson Family Management LTD Organization, Boyce, LA Adp of the SNF Dec 6, 2024
Sharlot Ponthie Individual 5% Or Greater Indirect Ownership Interest Aug 1, 2024 50%
Mark K Thompson Individual Adp of the SNF Jan 14, 2025
John R Russell Individual Operational/Managerial Control Dec 6, 2024
Adp of the SNF Jan 15, 2025
Southern Administrative Services, LLC Organization, Alexandria, LA LLC, Consulting firm Adp of the SNF Aug 1, 2024
Ross M Ponthie Individual Adp of the SNF Jan 14, 2025
Arkgpa LLC Organization, Houston, TX LLC Adp of the SNF Dec 6, 2024
Grace Ponthie Individual Adp of the SNF Jan 14, 2025
4P2T1 Ops Holding LP Organization, Houston, TX Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 1, 2024 100%
Adp of the SNF Dec 6, 2024
4P2T1 Asset Holding, LP Organization, Houston, TX Holding company Adp of the SNF Dec 6, 2024

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 38

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

View all 38

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1720396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773187200000",
    "number": "1427894567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 BORGOGNONI DR",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "716531623",
            "telephone_number": "870-265-5337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 BORGOGNONI DR",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "716531623",
            "telephone_number": "870-265-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE VILLAGE OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-08",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A",
        "authorized_official_last_name": "PONTHIE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "318-216-3316"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Village, AR

Sources for this page

Verify at the official NPI Registry.