NPIMap

Organization Active NPI

Ozark Health, Inc

  • Home Health Agency
  • Clinton, AR
National Provider Identifier
1487748034
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
4323 Issued in AR
Legal business name
OZARK HEALTH, INC
Practice address
428 Medical Center Parkway
Clinton, AR 72031
Phone
(501) 745-7004
Fax
(501) 745-5966
NPI assigned
Oct 3, 2006
Organization subpart
Yes
Parent organization
OZARK HEALTH, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 10, 2016

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

Authorized official

Name
David Deaton
Title
Administrator/Ceo
Phone
(501) 745-9531

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 4323 AR Primary

Addresses

Primary practice location

428 Medical Center Parkway
Clinton, AR 72031

Mailing address

PO Box 206
Clinton, AR 72031-0206
Phone (501) 745-7000

Other identifiers 2

IdentifierTypeStateIssuer
17167OtherARBCBS
135138514MedicaidAR

Other names 1

  • Ozark Health Home Care Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100216000855 AR Part A Provider - Home Health Agency 7315923620 Practice locations: Clinton, AR

Home health agency certification: CCN 047167

Legal name
OZARK HEALTH, INC
Doing business as
OZARK HEALTH HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 24, 1998
Last certification
Aug 9, 2019
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Dec 26, 1968 in AR
Enrollment address
428 Medical Center Pkwy
Clinton, AR 72031-7946
HHA Branch

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Ozark Health Home CareCCN 047167
Overall star rating
2 of 5
Ownership
Non-Profit
Certified
Jul 24, 1998
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2059206Ozark Health Homecare428 Medical Center Parkway, Clinton, AR 72031Certificate of waiverMay 19, 2027

National Provider Directory

National Provider Directory
Tax ID family
Ozark Health Medical Center Inc9 organizations share this tax ID, including this one
Part of
Ozark Health Medical Center Inc

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Rebecca Sutterfield Individual W-2 Managing Employee Jul 1, 2016
Jamie Beavers Individual Corporate Officer Aug 27, 2012
Mike W Lester Individual Corporate Officer May 30, 2019
Steve Schoettle Individual Corporate Director Dec 21, 2009
Melvin Morgan Individual Corporate Officer Jan 7, 2008
David Deaton Individual Corporate Officer Jun 25, 2012
Ozark Health, Inc Organization, Clinton, AR 5% Or Greater Direct Ownership Interest Jul 7, 1998
Cheryl Ragland Individual Corporate Officer Feb 23, 2017
William Ioup Individual Corporate Officer Apr 25, 2019
Shirl Williams Individual Corporate Officer May 30, 2019

Owners & managing parties with NPI records 7

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ozark Health Medical CenterClinton, AR, CCN 041313 Hospital 5% Or Greater Direct Ownership Interest Jan 7, 2008
Ozark Health Swing BedClinton, AR, CCN 04Z313 Hospital 5% Or Greater Direct Ownership Interest Jan 7, 2008

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 12

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": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478736000000",
    "number": "1487748034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 206",
            "city": "CLINTON",
            "state": "AR",
            "postal_code": "720310206",
            "telephone_number": "501-745-7000",
            "fax_number": "501-745-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 MEDICAL CENTER PARKWAY",
            "city": "CLINTON",
            "state": "AR",
            "postal_code": "72031",
            "telephone_number": "501-745-7004",
            "fax_number": "501-745-5966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OZARK HEALTH, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OZARK HEALTH, INC",
        "enumeration_date": "2006-10-03",
        "last_updated": "2016-11-10",
        "status": "A",
        "authorized_official_last_name": "DEATON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "ADMINISTRATOR/CEO",
        "authorized_official_telephone_number": "501-745-9531"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AR",
            "license": "4323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "17167",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135138514",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ozark Health Home Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clinton, AR

Sources for this page

Verify at the official NPI Registry.