NPIMap

Organization Active NPI

Jacqueline Kilgore LLC

  • Skilled Nursing Facility
  • Camden, AR
National Provider Identifier
1497973382
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
655 Issued in AR
Legal business name
JACQUELINE KILGORE LLC
Doing business as
LONGMEADOW NURSING CENTER
Practice address
365 Alpha St
Camden, AR 71701-3000
Phone
(870) 836-9337
Fax
(870) 836-5606
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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

Authorized official

Name
Avon Mitchell
Title
Office Manager
Phone
(501) 332-6934

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 655 AR Primary

Addresses

Primary practice location

365 Alpha St
Camden, AR 71701-3000

Mailing address

365 Alpha St
Camden, AR 71701-3000
Phone (870) 836-9337

Other names 1

  • LONGMEADOW NURSING CENTER Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350259200000",
    "number": "1497973382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 ALPHA ST",
            "city": "CAMDEN",
            "state": "AR",
            "postal_code": "717013000",
            "telephone_number": "870-836-9337",
            "fax_number": "870-836-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 ALPHA ST",
            "city": "CAMDEN",
            "state": "AR",
            "postal_code": "717013000",
            "telephone_number": "870-836-9337",
            "fax_number": "870-836-5606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACQUELINE KILGORE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2012-10-15",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "AVON",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "501-332-6934"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LONGMEADOW NURSING CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Camden, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; 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.