Organization Active NPI

Concordia Nursing & Rehab LLC

  • Skilled Nursing Facility
  • Bella Vista, AR
National Provider Identifier
1669893525
Registry record updated Apr 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CONCORDIA NURSING & REHAB LLC
Practice address
7 Professional Dr
Bella Vista, AR 72715-8462
Phone
(479) 855-3735
NPI assigned
Dec 19, 2013
Last updated
Apr 1, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2015

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

Authorized official

Name
Mr. Bradford Montgomery
Title
Member
Phone
(479) 715-6759

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

7 Professional Dr
Bella Vista, AR 72715-8462

Mailing address

1501 SE Walton Blvd
Suite 205
Bentonville, AR 72712-3734
Phone (479) 715-6759

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230503003578 AR Part A Provider - Skilled Nursing Facility 6901956168 Practice locations: Bella Vista, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669893525. Details of each certification follow.

Skilled nursing facility certification: CCN 045143

Legal name
CONCORDIA NURSING & REHAB LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 1, 1989
Last certification
May 6, 2025
Beds
102
Ownership / control type
Limited Liability Corporation
Most recent change of ownership
Jan 2, 2014
Organization structure
LLCProprietary
Incorporated
Apr 6, 2009 in AR
Enrollment address
7 Professional Dr
Bella Vista, AR 72715-8462
Nursing home name
CONCORDIA NURSING & REHAB, LLC
Affiliated entity
BRADFORD MONTGOMERY

Care Compare: Nursing home

Medicare Care Compare
Listed as
Concordia Nursing & Rehab, LLCCCN 045143 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jun 1, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10227.2 residents per day on average
Chain
Bradford Montgomery11 facilities in the chain
Special focus status
SFF Candidate
Penalties (3 years)
3Fines totaling $123,918

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

1501 SE Walton Blvd
Ste 205
Bentonville, AR 72712

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Bradford Montgomery Individual 5% Or Greater Direct Ownership Interest Jan 2, 2014
Corporate Director Jan 2, 2014
Nadine Huddleston Individual W-2 Managing Employee Jan 2, 2014

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": "1387411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427846400000",
    "number": "1669893525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 SE WALTON BLVD",
            "address_2": "SUITE 205",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123734",
            "telephone_number": "479-715-6759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 PROFESSIONAL DR",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727158462",
            "telephone_number": "479-855-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCORDIA NURSING & REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-19",
        "last_updated": "2015-04-01",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "479-715-6759",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bella Vista, AR

Sources for this page

Verify at the official NPI Registry.