Mine Creek Health and Rehab, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

776 Issued in AR

Legal business name

MINE CREEK HEALTH AND REHAB, LLC

Practice address

1407 N Main St
Nashville, AR 71852-3733

Phone

(870) 845-2012

NPI assigned

Aug 21, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Daniel Baird

Title

Manager

Phone

(410) 342-3155

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377043200000",
    "number": "1659705010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 CLARKVIEW RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212092385",
            "telephone_number": "410-342-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 N MAIN ST",
            "city": "NASHVILLE",
            "state": "AR",
            "postal_code": "718523733",
            "telephone_number": "870-845-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINE CREEK HEALTH AND REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-21",
        "last_updated": "2013-08-21",
        "status": "A",
        "authorized_official_last_name": "BAIRD",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "410-342-3155",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Med Southwest, PLLC
• Brittany Alexander Middleton
• Morgan Elle Miller, M.S. , SLP
• Sharonda Renee Miller, FNP
• Teresa Miller, MHPP
• Mine Creek Healthcare Center, LLC
• Mine Creek Holdings LLC
• Mine Creek Inpatient Services LLC
• Shawn Mitchell I
• Derrick Montgomery

• Skilled Nursing Facility in Nashville, AR
• Providers in Nashville, 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 21, 2013; 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.