White River Health System, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

625 Issued in AR

Legal business name

WHITE RIVER HEALTH SYSTEM, INC.

Doing business as

Stone County Nursing and Rehab Center

Practice address

706 Oak Grove St
Mountain View, AR 72560-8601

Phone

(870) 269-5835

Fax

(870) 269-2723

NPI assigned

Oct 31, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David D Jarvis, LNHA

Title

Associate Administator - LTC Divisi

Phone

(870) 269-6269

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Stone County Nursing and Rehab Center Doing business as

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219363200000",
    "number": "1457437568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 OAK GROVE ST",
            "city": "MOUNTAIN VIEW",
            "state": "AR",
            "postal_code": "725608601",
            "telephone_number": "870-269-5835",
            "fax_number": "870-269-2723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 OAK GROVE ST",
            "city": "MOUNTAIN VIEW",
            "state": "AR",
            "postal_code": "725608601",
            "telephone_number": "870-269-5835",
            "fax_number": "870-269-2723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE RIVER HEALTH SYSTEM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2008-08-22",
        "status": "A",
        "authorized_official_last_name": "JARVIS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ASSOCIATE ADMINISTATOR - LTC DIVISI",
        "authorized_official_telephone_number": "870-269-6269",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119628311",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stone County Nursing and Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• White River Health System, Inc.
• White River Health System, Inc.
• White River Health System, Inc.
• White River Health System, Inc.
• White River Health System, Inc.
• Jesse White
• Karen White, OTR
• Jedidiah Coy Whitt, MD
• Rebekah Wildmon
• Tonya Leigh Ann Wilkie

• Skilled Nursing Facility in Mountain View, AR
• Providers in Mountain View, 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, 2008; 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.