Ccnrc, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

758 Issued in AR

Legal business name

CCNRC, INC.

Practice address

500 Hammonds Ave
Berryville, AR 72616-4300

Phone

(870) 423-6966

Fax

(870) 368-4054

NPI assigned

Oct 17, 2005

Organization subpart

No

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

Authorized official

Name

Jay Nelson

Title

Owner

Phone

(870) 423-6966

Specialties & licenses 1

Addresses

Other names 1

• Carroll County Nursing and Rehab Center Doing business as

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649269259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 918",
            "city": "MELBOURNE",
            "state": "AR",
            "postal_code": "725560918",
            "telephone_number": "870-423-6966",
            "fax_number": "870-423-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HAMMONDS AVE",
            "city": "BERRYVILLE",
            "state": "AR",
            "postal_code": "726164300",
            "telephone_number": "870-423-6966",
            "fax_number": "870-368-4054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCNRC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-423-6966"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carroll County Nursing and Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shannon R. Card, MD
• Carroll County Learning Center
• Alexandria Carter
• Mildred Maxine Cary
• Roger Casady, MD
• Charles a. Beard, M.D., PA
• Sharon Chronister
• Jennifer Elizabeth Clay, LMSW
• Jill Cline, LCSW
• Allie Collins

• Skilled Nursing Facility in Berryville, AR
• Providers in Berryville, 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, 2020; 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.