NPIMap

Organization Active NPI

Baptist Health Extended Care Hospital - Little Rock, Inc.

  • Long Term Care Hospital
  • Little Rock, AR
National Provider Identifier
1447439708
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
License
AR4489 Issued in AR
Legal business name
BAPTIST HEALTH EXTENDED CARE HOSPITAL - LITTLE ROCK, INC.
Practice address
9601 Baptist Health Drive 10TH Floor
Little Rock, AR 72205
Phone
(501) 202-6000
NPI assigned
Nov 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Authorized official

Name
Troy Wells
Title
President
Phone
(501) 202-2080

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X AR4489 AR Primary
General Acute Care Hospital 282N00000X AR4489 AR

Addresses

Primary practice location

9601 Baptist Health Drive 10TH Floor
Little Rock, AR 72205

Mailing address

9601 Baptist Health Drive 10TH Floor
Little Rock, AR 72205
Phone (501) 202-2080

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071212000356 AR Part A Provider - Hospital 1850481003 Practice locations: Little Rock, AR

Hospital certification: CCN 042012

Legal name
BAPTIST HEALTH EXTENDED CARE HOSPITAL - LITTLE ROCK, INC.
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
Oct 1, 2008
Last certification
Feb 11, 2020
Beds
55
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Oct 23, 2007 in AR
Enrollment address
9601 Baptist Health Dr
10TH Floor
Little Rock, AR 72205-6321
Other Hospital Practice Location
Hospital subgroups
General, Acute care, Long-term

Care Compare: Long-term care hospital

Medicare Care Compare
Listed as
Baptist Health Extended Care Hospital-LR IncCCN 042012
Ownership
Non-profit
Certified
Oct 1, 2008
Medicare certification status
ActiveFrom the Provider of Services file
Beds
55

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

9601 Baptist Health Dr
Fl 10
Little Rock, AR 72205
Phone (501) 202-1095

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Baptist Health Organization, Little Rock, AR Corporation, Non-profit 5% Or Greater Direct Ownership Interest Feb 1, 2008 100%
Stanley L Kellar Individual Corporate Director Apr 24, 2015
Baptist Health Extended Care Hospital - Little Rock, Inc. Organization, Little Rock, AR Non-profit Operational/Managerial Control Feb 1, 2008
Gregory Stubblefield Individual Corporate Officer Feb 1, 2020
W-2 Managing Employee Feb 1, 2020
Steven D Weeks Individual Corporate Director Jan 1, 2015
William Howard Individual Corporate Director Jan 1, 2026
Michael Perkins Individual Corporate Director Jan 1, 2026

Owners & managing parties with NPI records 1

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

Facilities with the same owner 50

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

View all 50

Practitioners & affiliated clinicians

Affiliated clinicians 9

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": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617062400000",
    "number": "1447439708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9601 BAPTIST HEALTH DRIVE 10TH FLOOR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72205",
            "telephone_number": "501-202-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 BAPTIST HEALTH DRIVE 10TH FLOOR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72205",
            "telephone_number": "501-202-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST HEALTH EXTENDED CARE HOSPITAL - LITTLE ROCK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "TROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-202-2080"
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "AR",
            "license": "AR4489",
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "AR",
            "license": "AR4489",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.