Woodridge Northwest, LLC

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

License

237 Issued in AR

Legal business name

WOODRIDGE NORTHWEST, LLC

Doing business as

Perimeter Behavioral of the Ozarks
Woodridge of the Ozarks

Practice address

2466 S 48TH St
Springdale, AR 72762-6683

Phone

(615) 860-9230

Fax

(615) 860-9228

NPI assigned

May 6, 2016

Organization subpart

No

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

Authorized official

Name

Rochelle Gerber

Title

Avp of Administrative Services

Phone

(470) 554-7903

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Perimeter Behavioral of the Ozarks Doing business as
• Woodridge of the Ozarks Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Psychiatric residential treatment facility certification: CCN 04L120

Legal name

WOODRIDGE OF THE OZARKS

Certification status

Active

Provider type (POS)

Psychiatric residential treatment facility

Participating since

May 16, 2017

Last certification

Apr 7, 2022

Beds

28

Ownership / control type

Non-profit – corporation

Facility address

2466 S 48TH Street
Springdale, AR 72762

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1462492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637625600000",
    "number": "1689020844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 NORTHWINDS PKWY STE 550",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300092236",
            "telephone_number": "470-554-7903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2466 S 48TH ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626683",
            "telephone_number": "615-860-9230",
            "fax_number": "615-860-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODRIDGE NORTHWEST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-06",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A",
        "authorized_official_last_name": "GERBER",
        "authorized_official_first_name": "ROCHELLE",
        "authorized_official_title_or_position": "AVP OF ADMINISTRATIVE SERVICES",
        "authorized_official_telephone_number": "470-554-7903"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "AR",
            "license": "237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218443125",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Perimeter Behavioral of the Ozarks",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Woodridge of the Ozarks",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Woodridge of the Ozarks",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tami Alicia Wollner, LCSW
• Eric L. Wood, D.M.D
• Jessica Wood
• Stephanie Anne Wood, LAC
• Donna Woodie
• Katie Woolard, PHARM D.
• Stephanie M Wooley, PT, DPT
• Shannon J Woznick, CRNA
• Allison Anne Wright, LCSW
• Cara Wright, MD

• Psychiatric Residential Treatment Facility in Springdale, AR
• Providers in Springdale, AR by specialty
• Psychiatric Residential Treatment Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.