Everest Rehabilitation Hospital Bentonville, LLC

Primary specialty

Rehabilitation HospitalTaxonomy code 283X00000X

Legal business name

EVEREST REHABILITATION HOSPITAL BENTONVILLE, LLC

Practice address

4313 S. Pleasant Crossing Blvd.
Rogers, AR 72758

Phone

(469) 713-1145

NPI assigned

Aug 20, 2019

Organization subpart

No

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

Addresses

Other identifiers 1

Other names 1

• Everest Rehabilitation Hospital Bentonville Doing business as

Electronic endpoints 1

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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240572526",
            "state": "AR"
        }
    ],
    "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"
        }
    ]
}

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• Rehabilitation Hospital in Rogers, AR
• Providers in Rogers, AR by specialty
• Rehabilitation Hospital in Arkansas

• 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.

Verify at the official NPI Registry.