NPIMap

Organization Active NPI

Malvern Health and Rehab LLC

  • Skilled Nursing Facility
  • Malvern, AR
National Provider Identifier
1669100160
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MALVERN HEALTH AND REHAB LLC
Practice address
1820 W Moline St
Malvern, AR 72104-2644
Phone
(501) 337-9581
NPI assigned
Aug 11, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Authorized official

Name
John Ponthie
Title
Member
Phone
(318) 216-3316

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1820 W Moline St
Malvern, AR 72104-2644

Mailing address

7607 Fern Ave Ste 202
Shreveport, LA 71105-5699
Phone (318) 216-3316

Other names 1

  • ENCORE HEALTHCARE AND REHAB OF MALVERN Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220928001247 AR Part A Provider - Skilled Nursing Facility 1254717234 Practice locations: Malvern, AR

Skilled nursing facility certification: CCN 045393

Legal name
MALVERN HEALTH AND REHAB, LLC
Doing business as
ENCORE HEALTHCARE AND REHAB OF MALVERN
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 16, 2003
Last certification
Nov 21, 2024
Beds
108
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Jun 14, 2022 in AR
Enrollment address
1820 W Moline St
Malvern, AR 72104-2644
Nursing home name
ENCORE HEALTHCARE AND REHABI OF MALVERN
Affiliated entity
SOUTHERN ADMINISTRATIVE SERVICES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Encore Healthcare and Rehabi of MalvernCCN 045393
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Nov 16, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10884.1 residents per day on average
Chain
Southern Administrative Services35 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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
04D0675164Malvern Health and Rehab LLC1820 West Moline Street, Malvern, AR 72104Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

1820 W Moline St
Malvern, AR 72104
Phone (501) 337-9581

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Jej Assets LP Organization, Shreveport, LA Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jun 14, 2022 100%
Alexark1 LLC Organization, Shreveport, LA LLC, For-profit Operational/Managerial Control Jun 14, 2022 100%
Jej Management, LLC Organization, Shreveport, LA For-profit Operational/Managerial Control Jun 14, 2022 100%
John F Ponthie Individual 5% Or Greater Indirect Ownership Interest Aug 15, 2022 50%
Corporate OfficerAuthorized Signatory Aug 15, 2022 50%
Sharlot Ponthie Individual 5% Or Greater Indirect Ownership Interest Jun 14, 2022 50%
Hope D Bates Individual W-2 Managing EmployeeAdministrator Aug 15, 2022 100%
4P2T1 Ops Holding LP Organization, Houston, TX Holding company, For-profit 5% Or Greater Direct Ownership Interest Jan 14, 2022 100%

Facilities with the same owner 38

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

View all 38

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1660176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1669100160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7607 FERN AVE STE 202",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055699",
            "telephone_number": "318-216-3316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 W MOLINE ST",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721042644",
            "telephone_number": "501-337-9581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALVERN HEALTH AND REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-11",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "PONTHIE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "318-216-3316"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ENCORE HEALTHCARE AND REHAB OF MALVERN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Malvern, AR

Sources for this page

Verify at the official NPI Registry.