Madison Residential Care Facility

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

License

041 Issued in AR

Legal business name

MADISON RESIDENTIAL CARE FACILITY

Practice address

2821 W Dixon Rd
Little Rock, AR 72206-4256

Phone

(501) 888-4080

Fax

(501) 486-9119

NPI assigned

Dec 1, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Sy Niksefat

Title

Owner

Phone

(501) 888-4080

Specialties & licenses 1

Addresses

Other names 1

• Madison Health and Rehab Doing business as

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259625600000",
    "number": "1467780510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2821 W DIXON RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722064256",
            "telephone_number": "501-888-4080",
            "fax_number": "501-486-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 W DIXON RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722064256",
            "telephone_number": "501-888-4080",
            "fax_number": "501-486-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON RESIDENTIAL CARE FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-01",
        "last_updated": "2009-12-01",
        "status": "A",
        "authorized_official_last_name": "NIKSEFAT",
        "authorized_official_first_name": "SY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-888-4080",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "AR",
            "license": "041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madison Health and Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Courtland Maddox
• Jennifer Maddox
• Madison Health & Rehab LLC
• Madison Healthcare and Rehabilitation Center LLC
• Madison Healthcare and Rehabilitation Center LLC
• Stephanie Janine Magan, MSN, APRN, FNP-BC
• Everett F Magann, MD
• Marcia Magann, NP
• Kelly Magby, MHPP
• James S Magee, MD

• Physical Disabilities Residential Treatment Facility in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Physical Disabilities Residential Treatment Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; 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.