Diversicare Leasing Corp.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

543 Issued in AR

Legal business name

DIVERSICARE LEASING CORP.

Doing business as

Pocahontas Nursing and Rehabilitation Center

Practice address

105 Country Club Rd
Pocahontas, AR 72455-1364

Phone

(870) 892-2523

Fax

(870) 248-0378

NPI assigned

Oct 8, 2005

Last updated

Aug 22, 2020By 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

Raymond L. Tyler Jr.

Title

Executive Vice President and Coo

Phone

(615) 771-7575

Specialties & licenses 1

Addresses

Other names 1

• Pocahontas Nursing and Rehabilitation Center Doing business as

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

{
    "created_epoch": "1128729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780672360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 COUNTRY CLUB RD",
            "city": "POCAHONTAS",
            "state": "AR",
            "postal_code": "724551364",
            "telephone_number": "870-892-2523",
            "fax_number": "870-248-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 COUNTRY CLUB RD",
            "city": "POCAHONTAS",
            "state": "AR",
            "postal_code": "724551364",
            "telephone_number": "870-892-2523",
            "fax_number": "870-248-0378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSICARE LEASING CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TYLER",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT AND COO",
        "authorized_official_telephone_number": "615-771-7575",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pocahontas Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cole Evans Dickerson, DPT
• Cindy Difani, MCD,CCC-SLP
• Rhonda Difani, RN
• Tiffany Difani, OT
• Autumn Dillon
• Dozier Dental of Pocahontas PLLC (Family Dental Care of Pocahontas)
• Oliver Ray Dozier, DDS
• Dr. Karla Baltz, DDS, PA
• Misty Ronette Duckworth
• Eldercare of Arkansas II Inc. (Stonebridge of Pocahontas)

• Skilled Nursing Facility in Pocahontas, AR
• Providers in Pocahontas, 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 22, 2020; 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.