Poplar Grove Operations LLC
Organization Active NPI Skilled Nursing Facility · Little Rock, AR
NPI 1659858348 · NPPES record last updated Jul 31, 2018
Key facts
- NPI
- 1659858348
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- POPLAR GROVE OPERATIONS LLC
- Practice address
- 7801 Kanis Road
Little Rock, AR 72204 - Phone
- (501) 404-0500
- Fax
- (501) 404-0512
- NPI assigned
- Jul 25, 2018
- Organization subpart
- No
Authorized official
- Name
- Ross Ponthie
- Title
- Member
- Phone
- (318) 443-8167
Facilities with the same owner 36
Affiliated clinicians 2
-
Charles Wilson Smith Jr., M.D.
Medicare Care Compare: Nursing home
- Listed as
- The Green House Cottages of Poplar Grove
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★★★★ 5 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Dec 19, 2018
- Medicare certification status
- Active
- Certified beds
- 140 · 111.2 residents per day on average
- Chain
- Southern Administrative Services
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Skilled nursing facility certification: CCN 045466
- Legal name
- POPLAR GROVE OPERATIONS, LLC
- Doing business as
- THE GREEN HOUSE COTTAGES OF POPLAR GROVE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Dec 19, 2018
- Last certification
- Oct 4, 2024
- Beds
- 140
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC · Proprietary
- Incorporated
- Jun 2, 2017 in AR
- Enrollment address
- 7801 Kanis Road
Little Rock, AR 72204-2306 - Nursing home name
- THE GREEN HOUSE COTTAGES OF POPLAR GROVE
- Affiliated entity
- SOUTHERN ADMINISTRATIVE SERVICES
All disclosed owners & managing parties 13
| Name | Role | Since | Share |
|---|---|---|---|
| Jej Investments LLC |
5% Or Greater Indirect Ownership Interest | Jun 2, 2018 | 40% |
| Jej Assets LP |
5% Or Greater Indirect Ownership Interest | Jan 1, 2022 | |
| John Montgomery |
W-2 Managing Employee |
Sep 1, 2018 | 100% |
| Mark Kelly Thmpson 2020 Chikdren'S Trust |
5% Or Greater Direct Ownership Interest | Jun 2, 2017 | 20% |
| Alexark1 LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2022 | |
| Jej Management, LLC |
5% Or Greater Indirect Ownership Interest | Jan 1, 2022 | |
| Carnail Williams |
W-2 Managing Employee |
Apr 29, 2019 | 100% |
| Sonia Ingle |
Contracted Managing Employee | Sep 1, 2018 | |
| Ponthie Interests Inc |
5% Or Greater Indirect Ownership Interest | Jun 2, 2018 | |
| John F Ponthie |
5% Or Greater Indirect Ownership Interest | Jan 1, 2022 | |
| Corporate Director |
Jan 1, 2022 | ||
| Sharlot Ponthie |
5% Or Greater Indirect Ownership Interest | Jan 1, 2022 | |
| Angie Pratt |
Contracted Managing Employee | Sep 1, 2018 | |
| Trent M Unruh |
Contracted Managing Employee | Sep 1, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180817000222 | AR | Part a Provider - Skilled Nursing Facility | 0547519001 | Practice locations: Little Rock, AR |
National Provider Directory
Locations
7801 Kanis Rd
Little Rock, AR 72204
Phone (501) 404-0500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
7801 Kanis Road
Little Rock, AR 72204
Mailing address
PO Box 12187
Alexandria, LA 71315-2187
Phone (318) 443-8167
Other names
- THE GREEN HOUSE COTTAGES OF POPLAR GROVE
Other providers in Little Rock, AR
- Lindsey Jane Ponwith
- Amari Perrie Poole
- Kimberly Melissa Poole
- Christopher H Pope
- David Norton Pope
- Amanda Porchia-Washington
- Rekia Shanette Porchia
- Portable Audiometrics, Inc
- Angela Porter
- Ariel Porter
All providers in Little Rock, AR · Skilled Nursing Facility in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.