Active NPI
Everest Rehabilitation Hospital Bentonville, LLC
Doing business as Everest Rehabilitation Hospital Bentonville
- Rehabilitation Hospital
- Rogers, AR
National Provider Identifier
1699322164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Hospital
- Legal business name
- EVEREST REHABILITATION HOSPITAL BENTONVILLE, LLC
- Doing business as
- Everest Rehabilitation Hospital Bentonville
- Practice address
- 4313 S. Pleasant Crossing Blvd.
Rogers, AR 72758 - Phone
- (469) 713-1145
- NPI assigned
- Aug 20, 2019
- Last updated
- Aug 24, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Omar Jenkins
- Title
- Secretary & Treasurer
- Phone
- (469) 713-1145
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Hospital | 283X00000X | Primary |
Addresses
Primary practice location
4313 S. Pleasant Crossing Blvd.
Rogers, AR 72758
Mailing address
5100 Belt Line Rd Ste 310
Dallas, TX 75254-7124
Phone (469) 713-1145
Other names 1
- Everest Rehabilitation Hospital Bentonville
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
National Provider Directory
National Provider DirectoryLocations
5100 Belt Line Rd
Ste 310
Dallas, TX 75254
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566259200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1629763200000",
"number": "1699322164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5100 BELT LINE RD STE 310",
"city": "DALLAS",
"state": "TX",
"postal_code": "752547124",
"telephone_number": "469-713-1145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4313 S. PLEASANT CROSSING BLVD.",
"city": "ROGERS",
"state": "AR",
"postal_code": "72758",
"telephone_number": "469-713-1145"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EVEREST REHABILITATION HOSPITAL BENTONVILLE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-08-20",
"last_updated": "2021-08-24",
"certification_date": "2021-08-24",
"status": "A",
"authorized_official_last_name": "JENKINS",
"authorized_official_first_name": "OMAR",
"authorized_official_title_or_position": "SECRETARY & TREASURER",
"authorized_official_telephone_number": "469-713-1145"
},
"taxonomies": [
{
"code": "283X00000X",
"taxonomy_group": "",
"desc": "Rehabilitation Hospital",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.667.2",
"affiliationName": "Ability Network",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "100 N 6th St Ste 900A",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554031516",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Everest Rehabilitation Hospital Bentonville",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Everest Rehabilitation Hospital Bentonville",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Rogers, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.