Gyman LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

730 Issued in AR

Legal business name

GYMAN LLC

Doing business as

Golden Years Manor

Practice address

1010 Barnes Street
Lonoke, AR 72086

Phone

(501) 676-3103

Fax

(501) 676-7730

NPI assigned

Apr 11, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joey Martin Wiggins

Title

President

Phone

(501) 305-3153

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Golden Years Manor Doing business as

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437112125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2908 HAWKINS DRIVE",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "72143",
            "telephone_number": "501-305-3153",
            "fax_number": "501-279-3796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 BARNES STREET",
            "city": "LONOKE",
            "state": "AR",
            "postal_code": "72086",
            "telephone_number": "501-676-3103",
            "fax_number": "501-676-7730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GYMAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WIGGINS",
        "authorized_official_first_name": "JOEY",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-305-3153"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDIPAK",
            "identifier": "015314",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Golden Years Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Janet Renea Godfrey, B.S., MHPP
• Brody Wayne Goode, DPT
• Renee M. Grady, M.S., CCC-SLP
• Kimberly J Green-Kelley, RBT
• Gy Manor Nursing LLC (Golden Years Manor)
• Elizabeth Hall, PT,DPT
• Nancy Cloud Hamlin, LPC
• Wendy Sue Hanner, FNP-C, APRN
• Teresa Nadine Hardy, LPC
• Harmony Health Clinic Wynne, PLLC

• Skilled Nursing Facility in Lonoke, AR
• Providers in Lonoke, 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 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.