NPIMap

Organization Active NPI

Southern Caregivers of Star City

  • In Home Supportive Care Agency
  • Star City, AR
National Provider Identifier
1467003533
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
SOUTHERN CAREGIVERS OF STAR CITY
Practice address
1771 Green Hills Rd
Star City, AR 71667-8304
Phone
(870) 308-5132
NPI assigned
Sep 20, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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

Authorized official

Name
Blake Watson
Title
Owner
Phone
(870) 904-4277

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary
Attendant Care ProviderGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 3747A0650X
Personal Care AttendantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 3747P1801X
Respite Care 385H00000X

Addresses

Primary practice location

1771 Green Hills Rd
Star City, AR 71667-8304

Mailing address

709 Covenant PL
Searcy, AR 72143-6746
Phone (870) 308-5132

Other identifiers 3

IdentifierTypeStateIssuer
235434732MedicaidAR
235433797MedicaidAR
23540757MedicaidAR

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1568937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568937600000",
    "number": "1467003533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 COVENANT PL",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721436746",
            "telephone_number": "870-308-5132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771 GREEN HILLS RD",
            "city": "STAR CITY",
            "state": "AR",
            "postal_code": "716678304",
            "telephone_number": "870-308-5132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CAREGIVERS OF STAR CITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-20",
        "last_updated": "2019-09-20",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-904-4277"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "235434732",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "235433797",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23540757",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Star City, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; 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.