Dierks Health Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

DIERKS HEALTH OPCO LLC

Doing business as

Dierks Health and Rehab

Practice address

402 S Arkansas Ave
Dierks, AR 71833-9001

Phone

(870) 286-3100

Fax

(870) 286-3030

NPI assigned

Jun 1, 2022

Last updated

Aug 9, 2023By 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

Ethan Dreifus

Title

Authorized Signatory

Phone

(501) 961-8100

Specialties & licenses 1

Addresses

Other names 1

• Dierks Health and Rehab Doing business as

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1699414318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8250",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721458250",
            "telephone_number": "501-254-0007",
            "fax_number": "888-866-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 S ARKANSAS AVE",
            "city": "DIERKS",
            "state": "AR",
            "postal_code": "718339001",
            "telephone_number": "870-286-3100",
            "fax_number": "870-286-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIERKS HEALTH OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-01",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "DREIFUS",
        "authorized_official_first_name": "ETHAN",
        "authorized_official_title_or_position": "AUTHORIZED SIGNATORY",
        "authorized_official_telephone_number": "501-961-8100"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dierks Health and Rehab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dierks Health and Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Access Medical Clinic Arkansas LLC
• Karen Lee Allen
• Banyan Healthcare Services, LLC (Dierks Health & Rehab Center)
• Justin Bean
• Kelsi Dawn Brown
• Dierks Healthcare & Rehabilitation Center LLC
• Dierks School District
• Hannah Nicole Ellis
• Priscilla Ann Faulkner, LPC
• Shelby Gail Foshee

• Skilled Nursing Facility in Dierks, AR
• Providers in Dierks, 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 Aug 9, 2023; 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.