Stap, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

STAP, INC.

Doing business as

St. Andrews Place

Practice address

3501 College Ave
Conway, AR 72034-7281

Phone

(501) 329-9879

Fax

(501) 329-6673

NPI assigned

May 3, 2010

Last updated

Jun 10, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jenny June Kilgore, CPA

Title

Cfo

Phone

(479) 474-6885

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• St. Andrews Place Doing business as

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

{
    "created_epoch": "1272844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276128000000",
    "number": "1679890511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 MAIN ST",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729564957",
            "telephone_number": "479-474-6885",
            "fax_number": "479-474-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 COLLEGE AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720347281",
            "telephone_number": "501-329-9879",
            "fax_number": "501-329-6673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-03",
        "last_updated": "2010-06-10",
        "status": "A",
        "authorized_official_last_name": "KILGORE",
        "authorized_official_first_name": "JENNY",
        "authorized_official_middle_name": "JUNE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "479-474-6885",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181708311",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Andrews Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sydney Lee Stanisch
• Janet H Stannard, MD
• Erin Stanton
• Paige Stanton
• Thaddeus Michael Stanton, M.D.
• Kristen Stark
• Brittany Starkey
• Angela Starr
• State of Arkansas (Conway Human Development Center)
• State of Arkansas (Faulkner County Health Unit)

• Skilled Nursing Facility in Conway, AR
• Providers in Conway, 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 Jun 10, 2010; 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.